# DR. ELISSA ERMMARINO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114083466
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2013-01436 | NC | Yes |
| 207Q00000X | Family Medicine Physician | 20A7368 | CA | — |
| 207Q00000X | Family Medicine Physician | 212592 | NY | — |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 03/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2013-01436 | NORTH CAROLINA MEDICAL BOARD | NC |
| 01 | — | 20A7368 | CALIFORNIA MEDICAL LICENSE | CA |
| 01 | — | 212592 | NEW YORK MEDICAL LICENSE | NY |