Individual
ELISABETH RENAI LOCCISANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
Mailing address
PO BOX 1242, WEST BABYLON, NY 11704-0242
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
348313
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
06/30/2021
Last updated
08/23/2021
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