Kellie Anne Liwanag, RN
Registered Nurse, Psych/Mental Health in Staten Island, NY. Individual provider (NPI-1).
NPI number1679080493
StatusActive
Last updated in NPPESJan 2, 2018
Details
- NPI
- 1679080493
- Entity type
- Individual (NPI-1)
- Name
- Kellie Anne Liwanag
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 2, 2018
- Last updated
- Jan 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | 458372-1 | NY | Yes |
Practice location
777 Seaview AveStaten Island, NY 10305-3409
Phone 718-667-2300
Mailing address
777 Seaview AveStaten Island, NY 10305-3409
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