Healthcare Provider Details

I. General information

NPI: 1104422419
Provider Name (Legal Business Name): ELISSE ARROYO-FALCON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 PARK AVE
NEW YORK NY
10029-3810
US

IV. Provider business mailing address

1475 PARK AVE
NEW YORK NY
10029-3810
US

V. Phone/Fax

Practice location:
  • Phone: 212-426-3400
  • Fax:
Mailing address:
  • Phone: 212-426-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119558
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099502-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: