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General NPI Number Information
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NPI Number | 1174345847
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Entity Type | Organization
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Legal Business Name | ALLISON LISS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 610 TROY SCHENECTADY RD # 1069
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City | LATHAM
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State | NY
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Zip | 12110-2507
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Country | US
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Telephone | 518-336-0506
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Fax |
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Provider Business Mailing Address
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Address Line | 601 TROY SCHENECTADY RD
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City | LATHAM
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State | NY
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Zip | 12110-2813
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Country | US
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Telephone | 518-374-4443
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. ALLISON LISS
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Credential | PMHNP
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Telephone | 518-374-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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