Provider Demographics
NPI:1114673761
Name:PINTO, NASSTASIJIA NOELIA
Entity type:Individual
Prefix:
First Name:NASSTASIJIA
Middle Name:NOELIA
Last Name:PINTO
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 1:5900 ARLINGTON AVE APT 9J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1310
Mailing Address - Country:US
Mailing Address - Phone:646-775-7962
Mailing Address - Fax:
Practice Address - Street 1:78A N BOUNDARY RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11430-1820
Practice Address - Country:US
Practice Address - Phone:718-656-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily