Healthcare Provider Details

I. General information

NPI: 1114534575
Provider Name (Legal Business Name): ELIZABETH EPPLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH HARTIN NP

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ATRIA 36 E 57TH 5TH FLOOR
NEW YORK NY
10022
US

IV. Provider business mailing address

36 E 57TH 5TH FLOOR
NEW YORK NY
10022
US

V. Phone/Fax

Practice location:
  • Phone: 212-600-2000
  • Fax: 212-540-0855
Mailing address:
  • Phone: 212-600-2000
  • Fax: 212-540-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF346004
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberF3460004
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: