Provider Demographics
NPI:1942780390
Name:KLESHCHANKA, NATALLIA (FNP)
Entity type:Individual
Prefix:
First Name:NATALLIA
Middle Name:
Last Name:KLESHCHANKA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-1504
Mailing Address - Country:US
Mailing Address - Phone:347-672-0805
Mailing Address - Fax:347-745-7019
Practice Address - Street 1:3350 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6792
Practice Address - Country:US
Practice Address - Phone:347-672-0805
Practice Address - Fax:347-745-7019
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily