Individual
MS. LISA VERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9131 QUEENS BLVD STE 222, ELMHURST, NY 11373-5511
(718) 896-3400
Mailing address
6905 51ST AVE, WOODSIDE, NY 11377-7601
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F-401988
NY
Other
Enumeration date
07/29/2016
Last updated
03/04/2021
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