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General NPI Number Information
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NPI Number | 1568712552
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Entity Type | Organization
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Legal Business Name | YUNIQUE DESIRE-BRISARD FNP LNC
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 380 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11223-4046
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Country | US
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Telephone | 646-648-1160
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Fax |
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Provider Business Mailing Address
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Address Line | 1339 E 104TH ST
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City | BROOKLYN
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State | NY
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Zip | 11236-4507
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | YUNIQUE DESIRE-BRISARD
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Credential | NP
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Telephone | 646-648-1160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 333149
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License Number State | NY
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