Individual
PHOEBE SUSAN ELMENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
34 MAPLE ST, NORWALK, CT 06850-3815
(203) 852-2160
Mailing address
55 PARK AVE, POUGHKEEPSIE, NY 12603-3101
(845) 337-6380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5759
CT
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
05/07/2024
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