| NPI | 1669071775 |
|---|---|
| Doing Business As | DESTINY MEDICAL PRACTICE LLC |
| Entity Type | Organization |
| Authorized Contact | VIDA-LYNN ASIAMAH- ASARE Owner 917-204-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-11-24 |