Sage, Elise Mariam

Sage, Elise Mariam is an individual health care provider with primary practice located at 869 Forbes St , East Hartford CT 06118-1958. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Sage, Elise Mariam can be contacted via phone (860) 622-5343.

Contact Information

Primary practice address
869 Forbes St East Hartford CT 06118-1958
Phone: (860) 622-5343
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2268080 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 12.005079 Connecticut
Nursing Service Providers / Registered Nurse 163W00000X 10.107616 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 005079 Connecticut

Profile Details

NPI number 1598048878
LBN Legal business name Sage, Elise Mariam
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2011
Last updated Jul 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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