Individual
ELISE LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
09/23/2022
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