Individual
ELISSA H KRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
712 MAIN ST, ISLIP, NY 11751-3620
(631) 666-3951
(631) 666-3994
Mailing address
712 MAIN ST, ISLIP, NY 11751-3620
(631) 666-3951
(631) 666-3994
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308873
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
308873
LICENSE REGISTRATION
NY
Enumeration date
09/25/2018
Last updated
09/25/2018
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