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General NPI Number Information
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NPI Number | 1295750479
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Entity Type | Individual
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Provider Name | ELANA MARIE ROSE CONTORNO PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 36500 AURORA DR
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City | SUMMIT
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State | WI
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Zip | 53066
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Country | US
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Telephone | 262-434-1000
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Fax | 262-434-5050
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Provider Business Mailing Address
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Address Line | 36500 AURORA DR
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City | SUMMIT
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State | WI
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Zip | 53066-4899
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Country | US
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Telephone | 262-434-1000
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Fax | 262-434-5050
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1115
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License Number State | WI
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