Provider Demographics
NPI:1013158443
Name:GREEN, ELISA PASIA (APN-BC)
Entity Type:Individual
Prefix:MRS
First Name:ELISA
Middle Name:PASIA
Last Name:GREEN
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 536745
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15253-5909
Mailing Address - Country:US
Mailing Address - Phone:973-366-6060
Mailing Address - Fax:973-366-1423
Practice Address - Street 1:195 ROUTE 46
Practice Address - Street 2:SUITE 102
Practice Address - City:MINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:07803-3163
Practice Address - Country:US
Practice Address - Phone:973-366-6060
Practice Address - Fax:973-366-1423
Is Sole Proprietor?:No
Enumeration Date:2009-03-15
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00188300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health