Provider Demographics
NPI:1558317420
Name:PIZZI, ELISE ROBINSON (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ELISE
Middle Name:ROBINSON
Last Name:PIZZI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 S 21ST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-3401
Mailing Address - Country:US
Mailing Address - Phone:215-925-3566
Mailing Address - Fax:215-925-2990
Practice Address - Street 1:2130 S 21ST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-3401
Practice Address - Country:US
Practice Address - Phone:215-925-3566
Practice Address - Fax:215-925-2990
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004082H363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA528219K9LMedicare ID - Type Unspecified
PAS31544Medicare UPIN