Basic Information
| Provider Information | |||||||||
| NPI: | 1104115989 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLEYSHER | ||||||||
| FirstName: | LARISA | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5520 PARK AVE | ||||||||
| Address2: | |||||||||
| City: | TRUMBULL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066113463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035028400 | ||||||||
| FaxNumber: | 2035028409 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 MAPLE ST | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068503815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038522204 | ||||||||
| FaxNumber: | 2038523109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2011 | ||||||||
| LastUpdateDate: | 08/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4583 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.