Healthcare Provider Details

I. General information

NPI: 1164355111
Provider Name (Legal Business Name): ELITE SANTE PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BOSTON RD
BILLERICA MA
01821-1888
US

IV. Provider business mailing address

382 TREBLE COVE RD
NORTH BILLERICA MA
01862-2823
US

V. Phone/Fax

Practice location:
  • Phone: 978-775-2777
  • Fax:
Mailing address:
  • Phone: 781-267-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BERENICE KOBU
Title or Position: NURSE PRACTITIONER/OWNER
Credential:
Phone: 781-267-2131