Individual
MRS. ELISSA LEBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
27 KINGHORN ST, STATEN ISLAND, NY 10312-6113
(718) 967-1171
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
010005
NY
Other
Enumeration date
10/30/2007
Last updated
06/04/2008
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