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General NPI Number Information
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NPI Number | 1245372044
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Entity Type | Individual
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Provider Name | MALISA NUZZI RPA-C
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 955 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0321
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Country | US
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Telephone | 212-570-2067
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Fax |
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Provider Business Mailing Address
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Address Line | 955 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0321
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Country | US
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Telephone | 212-570-2067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 010720
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10720
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License Number State | NY
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