Individual
ELISA KAY FREIRE-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
44 PENNY DR, HUNTINGTON STATION, NY 11746-3423
(631) 673-0930
Mailing address
44 PENNY DR, HUNTINGTON STATION, NY 11746-3423
(631) 673-0930
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
005600-1
NY
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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