Healthcare Provider Details

I. General information

NPI: 1073274049
Provider Name (Legal Business Name): LISA SCARLATELLA ARNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA SCARLATELLA ARNP

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 MADISON AVE RM 1501
NEW YORK NY
10016-0701
US

IV. Provider business mailing address

285 MADISON AVE
MADISON NJ
07940-1006
US

V. Phone/Fax

Practice location:
  • Phone: 212-203-1773
  • Fax:
Mailing address:
  • Phone: 973-443-8535
  • Fax: 973-443-8174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26NJ01245300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ01245300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: