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General NPI Number Information
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NPI Number | 1821606963
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Entity Type | Individual
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Provider Name | ELISABETH BATES MSN, RN, CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 180 FORT WASHINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10032-3722
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Country | US
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Telephone | 212-305-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 1818 CORNELIA ST UNIT 1
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4918
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Country | US
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Telephone | 508-524-7017
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 383079
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License Number State | NY
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