Individual
EMILY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
(631) 686-7697
Mailing address
625 BELLE TERRE RD, SUITE 100, PORT JEFFERSON, NY 11777-2316
(631) 473-1320
(631) 686-7697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003309
NY
Other
Enumeration date
10/13/2006
Last updated
05/11/2015
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