Individual
MRS. ELIZABETH ISTORICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
710 W 168TH ST, NI-I ROOM 18, NEW YORK, NY 10032-3726
(212) 305-1718
(212) 305-1716
Mailing address
710 W 168TH ST, NI-I ROOM 18, NEW YORK, NY 10032-3726
(212) 305-1718
(212) 305-1716
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F333486-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02739760
—
NY
Enumeration date
05/15/2006
Last updated
08/29/2008
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