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General NPI Number Information
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NPI Number | 1396086815
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Entity Type | Individual
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Provider Name | ALLISON LISS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 2215 BURDETT AVE
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City | TROY
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State | NY
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Zip | 12180-2466
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Country | US
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Telephone | 518-270-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 601 TROY SCHENECTADY RD # 1069
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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 |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 597703
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401592
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License Number State | NY
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