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General NPI Number Information
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NPI Number | 1831320902
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Entity Type | Individual
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Provider Name | ELISSA PRESNER P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 25-10 30TH AVENUE, MOUNT SINAI OF QUEENS DEPT OF EMERGENCY MEDICINE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11102
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Country | US
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Telephone | 718-932-4390
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Fax |
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Provider Business Mailing Address
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Address Line | 50 CHRISTOPHER COLUMBUS DR APT 2508
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City | JERSEY CITY
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State | NJ
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Zip | 07302-7005
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012894
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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 | 25MP00212200
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License Number State | NJ
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