Provider Demographics
NPI:1225627912
Name:BEST, CARISSA REBECCA (NP)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:REBECCA
Last Name:BEST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2488 BROADWAY STE 1625
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7489
Mailing Address - Country:US
Mailing Address - Phone:646-946-6826
Mailing Address - Fax:929-667-7379
Practice Address - Street 1:2488 BROADWAY STE 1625
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7489
Practice Address - Country:US
Practice Address - Phone:646-946-6826
Practice Address - Fax:929-667-7379
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCRN1061066363LP0808X, 363LP0808X
NY403453363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty