# ELISE MCKENNA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548670300
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | MD047525 | DC | — |
| 2086S0120X | Pediatric Surgery Physician | 25MA12859100 | NJ | Yes |
| 2086S0120X | Pediatric Surgery Physician | 325457 | NY | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | CT | — |

## Other

- **Enumeration date:** 05/02/2014
- **Last updated:** 09/24/2026