Individual
MRS. LAURA PAVEL KETELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5316 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2591
(833) 660-7246
Mailing address
10 SHENANDOAH BLVD, PORT JEFFERSON STATION, NY 11776-2022
(703) 314-4055
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128906
FL
Other
Enumeration date
01/30/2020
Last updated
09/12/2023
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