Provider Demographics
NPI:1336369453
Name:KELLY-ROSSINI, ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KELLY-ROSSINI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LIZA
Other - Middle Name:
Other - Last Name:KELLY-ROSSINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1305 YORK AVENUE, Y-767
Mailing Address - Street 2:WEILL CORNELL MEDICAL COLLEGE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:646-962-2065
Mailing Address - Fax:
Practice Address - Street 1:1305 YORK AVENUE
Practice Address - Street 2:WEILL CORNELL MEDICAL COLLEGE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:646-962-2065
Practice Address - Fax:646-962-1604
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302601363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health