Johanna Derisca
Johanna Derisca is a Nurse Practitioner in New York, New York. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in New York.
- Years since qualifying
- 3
- Licensed in
- NY
- In the registry since
- 2025
Practice location Address checks out
506 Lenox AveNew York, NY 10037-1802
Phone: (844) 692-4692
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Acute Care Nurse Practitioner (primary) | Taxonomy 363LA2100X · Licence 432908 (NY) |
|---|
Record details
| NPI number | 1205639895 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 29, 2025 |
| Last updated in NPPES | March 29, 2025 |
| Certification date | March 29, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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