Provider Demographics
NPI:1992197743
Name:MONFISTON, NATHALIE JENNIFER (NP)
Entity Type:Individual
Prefix:MS
First Name:NATHALIE
Middle Name:JENNIFER
Last Name:MONFISTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 ROCKAWAY PKWY APT 5V
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4336
Mailing Address - Country:US
Mailing Address - Phone:347-782-8615
Mailing Address - Fax:
Practice Address - Street 1:1625 ROCKAWAY PKWY APT 5V
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4336
Practice Address - Country:US
Practice Address - Phone:347-782-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307041363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health