Provider Demographics
NPI:1174345847
Name:ALLISON LISS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:ALLISON LISS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LISS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:518-374-4443
Mailing Address - Street 1:601 TROY SCHENECTADY RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2813
Mailing Address - Country:US
Mailing Address - Phone:518-374-4443
Mailing Address - Fax:
Practice Address - Street 1:610 TROY SCHENECTADY RD # 1069
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2507
Practice Address - Country:US
Practice Address - Phone:518-336-0506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty