| Organization Name: | LISA A NELSON NP-PSYCHIATRY |
| NPI Number: | 1700271020 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA NELSON (OWNER) |
| Mailing Address: | 3771 Nesconset Hwy Suite 212 South Setauket |
| State: | NY US |
| Postal Code: | 117201163 |
| Phone Number: | 6316895390 |
| Fax Number: | 6316895395 |
| NPI Enumeration Date: | 04/02/2015 |
| NPI Last Update Date: | 03/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | F401077 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |