Individual
MS. DOREEN MASSEY ELITHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794
(631) 444-8333
(634) 444-8825
Mailing address
STONY BROOK UNIVERSITY MEDICAL CTR, DEPT. OF SURGERY,DIVISION -VASCULAR SURGERY-HSC 19-020, STONY BROOK, NY 11794-8191
(631) 444-4388
(631) 444-8824
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
304257
NY
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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