Provider Demographics
NPI:1730901448
Name:ELYSARA LLC
Entity type:Organization
Organization Name:ELYSARA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASIZZI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:888-635-9727
Mailing Address - Street 1:33 WALT WHITMAN RD STE 208E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3640
Mailing Address - Country:US
Mailing Address - Phone:888-635-9727
Mailing Address - Fax:888-635-9727
Practice Address - Street 1:33 WALT WHITMAN RD STE 208E
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3640
Practice Address - Country:US
Practice Address - Phone:888-635-9727
Practice Address - Fax:888-635-9727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty