Provider Demographics
NPI:1780560847
Name:HEALING NEST WOUND CARE AND SERVICES LLC
Entity type:Organization
Organization Name:HEALING NEST WOUND CARE AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:ADJARATH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIALLO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-891-0121
Mailing Address - Street 1:105 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4514
Mailing Address - Country:US
Mailing Address - Phone:347-891-0121
Mailing Address - Fax:
Practice Address - Street 1:105 RIDGE DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4514
Practice Address - Country:US
Practice Address - Phone:347-891-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty