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General NPI Number Information
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NPI Number | 1164355111
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Entity Type | Organization
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Legal Business Name | ELITE SANTE PLUS
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 333 BOSTON RD
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City | BILLERICA
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State | MA
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Zip | 01821-1888
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Country | US
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Telephone | 978-775-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 382 TREBLE COVE RD
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City | NORTH BILLERICA
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State | MA
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Zip | 01862-2823
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Country | US
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Telephone | 781-267-2131
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | BERENICE KOBU
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Credential |
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Telephone | 781-267-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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