Provider Demographics
NPI:1598110454
Name:CUTRONA, ELISE
Entity Type:Individual
Prefix:MS
First Name:ELISE
Middle Name:
Last Name:CUTRONA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:CUTRONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN,MSN,CPNP
Mailing Address - Street 1:60 W 142ND ST
Mailing Address - Street 2:15-H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1104
Mailing Address - Country:US
Mailing Address - Phone:917-816-3087
Mailing Address - Fax:
Practice Address - Street 1:60 W 142ND ST
Practice Address - Street 2:15-H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1104
Practice Address - Country:US
Practice Address - Phone:917-816-3087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY489184163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse