| NPI | 1467806273 | 
|---|---|
| Former Name | ELISSA KALIVAS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00691800) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F430956-1) | 
| Enumeration Date | 2016-04-18 | 
| Last Update Date | 2024-08-22 |