Provider Demographics
NPI:1760375828
Name:SIERRA, ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MARCUS AVE STE N210
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1035
Mailing Address - Country:US
Mailing Address - Phone:516-354-3278
Mailing Address - Fax:516-354-2700
Practice Address - Street 1:2001 MARCUS AVE STE N210
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1035
Practice Address - Country:US
Practice Address - Phone:516-354-3278
Practice Address - Fax:516-354-2700
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2769623363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner