Individual provider Active NPI

Misty Sioson Lalic, RN

  • Psychiatric/Mental Health Registered Nurse
  • Bronx, NY
National Provider Identifier
1811671969
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
612376 Issued in NY
Practice address
2840 Wellman Ave FL 1
Bronx, NY 10461-5583
Phone
(917) 773-7910
NPI assigned
Jun 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 612376 NY Primary

Addresses

Primary practice location

2840 Wellman Ave FL 1
Bronx, NY 10461-5583

Mailing address

2840 Wellman Ave FL 1
Bronx, NY 10461-5583
Phone (917) 773-7910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
612376NYMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1811671969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 WELLMAN AVE FL 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615583",
            "telephone_number": "917-773-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 WELLMAN AVE FL 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615583",
            "telephone_number": "917-773-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALIC",
        "first_name": "MISTY",
        "middle_name": "SIOSON",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "612376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.