Healthcare Provider Details

I. General information

NPI: 1699228544
Provider Name (Legal Business Name): ELISE DONATELLI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELISE KARWOSKI NP

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1200 S CONKLING ST APT 403
BALTIMORE MD
21224-5222
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5000
  • Fax:
Mailing address:
  • Phone: 631-807-6851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number430940
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR223523
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number586347
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR223523
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: