| Doctor Name: | ELYSSE LERIOTIS |
| NPI Number: | 1063898443 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP015165 |
| Business Practice Address: | 4075 Monroeville Blvd Suite 125 Monroeville, PA - 151462525 |
| Business Phone Number: | 4123731717 |
| Business Fax Number: | 4128568460 |
| Mailing Address: | 11279 Perry Hwy, Suite 450 WEXFORD |
| State: | PA |
| Postal Code: | 150909381 |
| Phone Number: | 7249331100 |
| Fax Number: | 7249331160 |
| NPI Enumeration Date: | 08/07/2015 |
| NPI Last Update Date: | 08/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | SP015165 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |