Healthcare Provider Details

I. General information

NPI: 1154230746
Provider Name (Legal Business Name): KATRINA MISANINA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 8TH AVE
NEW YORK NY
10001-4838
US

IV. Provider business mailing address

355 8TH AVE APT 6A
NEW YORK NY
10001-4842
US

V. Phone/Fax

Practice location:
  • Phone: 646-288-6344
  • Fax:
Mailing address:
  • Phone: 646-288-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF359254
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: