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General NPI Number Information
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NPI Number | 1023876430
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Entity Type | Individual
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Provider Name | MISS KAITLYN SBROLLINI
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Gender | Female
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 100 NICOLLS RD
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City | STONY BROOK
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State | NY
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Zip | 11794-0001
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Country | US
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Telephone | 631-331-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 35 DOWNING RD
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-7521
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Country | US
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Telephone | 845-625-4938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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