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General NPI Number Information
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NPI Number | 1609210707
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Entity Type | Individual
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Provider Name | WESLLYNE THERASSE NP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1621 EASTCHESTER RD
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City | BRONX
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State | NY
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Zip | 10461-2604
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Country | US
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Telephone | 718-405-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 11 ATLAS PL
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City | MOUNT VERNON
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State | NY
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Zip | 10552-1506
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Country | US
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Telephone | 845-494-9691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 339986
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 408014
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 583166
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 421093
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License Number State | NY
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