Individual
DR. ELISA ANTOINETTE LIVANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1430 BROADWAY, SUITE 304, NEW YORK, NY 10018-9226
(212) 840-8410
(212) 840-8415
Mailing address
1430 BROADWAY, SUITE 304, NEW YORK, NY 10018-9226
(212) 840-8410
(212) 840-8415
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
020922
NY
Other
Enumeration date
12/05/2014
Last updated
01/19/2018
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