| NPI | 1740067859 |
|---|---|
| Other Name | ELIVASION |
| Entity Type | Organization |
| Authorized Contact | CINDY-ANNE WILLIAMS Clinical Director 631-816-8054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |