Organization · Type 2 NPI
Desta Anthony Mobile NP Adult Health, PLLC
Adult Health Nurse Practitioner · Manlius, NY
NPI number
1679188494
Active
Practice location
8241 Penstock Way
Manlius, NY 13104-9401
Fax (315) 692-4292
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | None listed |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1679188494
Desta Anthony Mobile NP Adult Health, PLLC's National Provider Identifier is 1679188494, issued on Sep 9, 2020. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Manlius, NY. The record was last updated on Nov 28, 2025.