Provider Demographics
NPI:1659764553
Name:DEGUIA-RAYOS, JOANNE (ANP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DEGUIA-RAYOS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 OLD WESTBURY RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1611
Mailing Address - Country:US
Mailing Address - Phone:718-395-6444
Mailing Address - Fax:718-395-6661
Practice Address - Street 1:70 OLD WESTBURY RD
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1611
Practice Address - Country:US
Practice Address - Phone:718-395-6444
Practice Address - Fax:718-395-6661
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF307159363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health