| NPI | 1619477171 |
|---|---|
| Former Name | JEANNE MARIE GUALTIERI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 402347) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402347) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-06-16 |