Ellis, Carissa

Ellis, Carissa is an sole proprietor health care provider with primary practice located at 74 Mill Dr , Mastic Beach NY 11951-1403. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Ellis, Carissa can be contacted via phone (631) 578-5758.

Contact Information

Primary practice address
74 Mill Dr Mastic Beach NY 11951-1403
Phone: (631) 578-5758
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 22 717140 New York

Profile Details

NPI number 1740632496
LBN Legal business name Ellis, Carissa
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2016
Last updated Jul 6th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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