# LIANDRA WAISOME NURSE PRACTITIONER IN PSYCHIATRY, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700741634
- **Authorized official:** LIANDRA WAISOME EDWARDS (MANAGING MEMBER)
- **Authorized official phone:** (917) 748-5699

## Contact information

- **Practice address:** 469 DELAFIELD AVE, STATEN ISLAND, NY 10310-2012
- **Practice address phone:** (917) 748-5699
- **Mailing address:** 469 DELAFIELD AVE, STATEN ISLAND, NY 10310-2012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/23/2025
- **Last updated:** 12/23/2025