NPI 1023833977

Kathleen Fanelli

Practitioner Acute Care Nurse Practitioner Port Jefferson, NY

Practice location

Address: 75 N Country Rd, Port Jefferson, NY 11777-2119
Phone: (631) 473-1320
Mailing address: 77 Pacific Ave, Deer Park, NY 11729-3141

Registered specialties

Acute Care Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LA2100X Licence F433058-01 (NY)

Other Nurse Practitioner providers in New York →

Registry record

NPI: 1023833977
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Nov 2024
Record last updated: 20 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.