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General NPI Number Information
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NPI Number | 1649656679
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Entity Type | Individual
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Provider Name | AISHA SMITH-ELLIS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 175 MEMORIAL HWY STE 2-1
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5635
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Country | US
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Telephone | 914-235-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 626 RIVERSIDE DR 6B
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City | NEW YORK
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State | NY
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Zip | 10031-7201
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Country | US
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Telephone | 914-325-2400
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F307359-1
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License Number State | NY
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