Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 204108 | NY |
NPI | 1245315456 |
---|---|
Provider Name | Dr. Elaine May Arcenas |
First Address | Bay Shore, NY 11706-4746 |
Second Address | Bay Shore, NY 11706-6924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |