Individual
MS. KAYLA LAURELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 806-4805
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029089
NY
Other
Enumeration date
11/08/2022
Last updated
10/04/2023
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