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Individual

KATELIN L ELENTERIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
70 N COUNTRY RD STE 201, PORT JEFFERSON, NY 11777-2161
(631) 331-0200
Mailing address
70 N COUNTRY RD STE 201, PORT JEFFERSON, NY 11777-2161
(631) 331-0200

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
542117
NY
363L00000X
Nurse Practitioner
Primary
309150
NY

Other

Enumeration date
04/29/2019
Last updated
04/30/2019
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