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NPI Code Detail

MEDICARE: DR. ELISA LYNN NASSOIY D.C.

MEDICARE:  DR. ELISA LYNN NASSOIY  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor011954NY

General Provider Information

NPI Number : 1811229347
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELISA LYNN NASSOIY D.C.
Provider Business Mailing Address
First Line : 680 CAYUGA DR
Second Line :
City : LEWISTON
State : NY
Zip : 14092-1850
Country : US
Telephone Number : 716-754-7159
Fax Number :
Provider Business Practice Location Address
First Line : 101 LANG BLVD
Second Line :
City : GRAND ISLAND
State : NY
Zip : 14072-1601
Country : US
Telephone Number : 716-774-0442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2010
Last Update Date : 05/10/2011

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