Provider Demographics
NPI:1386519551
Name:PLISAK, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PLISAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 31ST AVE # CF
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4833
Mailing Address - Country:US
Mailing Address - Phone:347-403-3420
Mailing Address - Fax:
Practice Address - Street 1:1214 31ST AVE # CF
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4833
Practice Address - Country:US
Practice Address - Phone:347-403-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP138980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health