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Individual

MS. ELYSE MARIE ELISANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
180 OLD TAPPAN RD BLDG 32ND, OLD TAPPAN, NJ 07675-7052
(201) 995-1004
(201) 345-7121
Mailing address
101 WILLOW DR, OLD TAPPAN, NJ 07675-6833
(551) 579-9210

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05994800
NJ

Other

Enumeration date
01/27/2021
Last updated
01/27/2021
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