Individual
ELIZABETH A WYSOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8321
(516) 663-2184
Mailing address
25 E POPLAR ST, FLORAL PARK, NY 11001-3144
(516) 328-0337
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
33105-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F3344307-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01521466
—
NY
Enumeration date
01/02/2007
Last updated
03/21/2008
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