Individual
ELISABETH VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-1107
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-4098
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
301439-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02154112
—
NY
Enumeration date
07/12/2006
Last updated
04/04/2008
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