Provider Demographics
NPI:1265043814
Name:NUESI, DESIRET
Entity Type:Individual
Prefix:
First Name:DESIRET
Middle Name:
Last Name:NUESI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4912
Mailing Address - Country:US
Mailing Address - Phone:516-470-4700
Mailing Address - Fax:
Practice Address - Street 1:265 PENINSULA BLVD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4912
Practice Address - Country:US
Practice Address - Phone:516-470-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist