Provider Demographics
NPI:1558499855
Name:PONCHIONE, ELIZABETH C (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:PONCHIONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:BOX99
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-5149
Mailing Address - Fax:212-746-8416
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX99
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-5149
Practice Address - Fax:212-746-8416
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430486363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care