Healthcare Provider Details

I. General information

NPI: 1891876876
Provider Name (Legal Business Name): ELAINE ACCORSINI P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 WEST AVE
NORWALK CT
06850
US

IV. Provider business mailing address

3 TIMBERWOOD PL
SOUTH SALEM NY
10590-2112
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2417
  • Fax:
Mailing address:
  • Phone: 914-533-6709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number000833
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: