Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ00181300 | NJ |
NPI | 1023473162 |
---|---|
Provider Name | Elise Weisman |
First Address | Scotch Plains, NJ 07076-2925 |
Second Address | Stirling, NJ 07980-1010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2015 |
Last Update Date | 16/12/2015 |