Provider Demographics
NPI:1386764801
Name:MIZERIK, AMBER ELISE (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:ELISE
Last Name:MIZERIK
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:345 E 94TH ST
Mailing Address - Street 2:APT. 18B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5684
Mailing Address - Country:US
Mailing Address - Phone:772-485-5071
Mailing Address - Fax:212-600-4698
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:8N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-5475
Practice Address - Fax:212-305-8271
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-03-10
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Provider Licenses
StateLicense IDTaxonomies
NY011464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant