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General NPI Number Information
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NPI Number | 1750684684
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Entity Type | Individual
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Provider Name | BESARTA BERISHA N. P.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 10 LOCUST ST
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City | GLEN COVE
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State | NY
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Zip | 11542-2393
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Country | US
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Telephone | 646-271-7418
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Fax |
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Provider Business Mailing Address
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Address Line | 1129 NORTHERN BLVD STE 101
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City | MANHASSET
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State | NY
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Zip | 11030-3022
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Country | US
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Telephone | 516-676-7079
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F307924-1
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License Number State | NY
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