Healthcare Provider Details

I. General information

NPI: 1962082131
Provider Name (Legal Business Name): TATIANA VANESSA DUPLESSIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2581 ATLANTIC AVE
BROOKLYN NY
11207-2412
US

IV. Provider business mailing address

44 W 28TH ST
NEW YORK NY
10001-4212
US

V. Phone/Fax

Practice location:
  • Phone: 718-495-6700
  • Fax: 646-988-2840
Mailing address:
  • Phone: 212-545-2409
  • Fax: 212-463-8411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF345226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: