Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00188300 | NJ |
NPI | 1013158443 |
---|---|
Provider Name | Mrs. Elisa Pasia Green |
First Address | Pittsburgh, PA 15253-5909 |
Second Address | Mine Hill, NJ 07803-3163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2009 |
Last Update Date | 10/12/2020 |