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General NPI Number Information
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NPI Number | 1336522317
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Entity Type | Individual
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Provider Name | MRS. STORY ELMORE
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Gender | Female
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 265 BROADHOLLOW RD STE 200
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City | MELVILLE
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State | NY
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Zip | 11747-4833
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Country | US
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Telephone | 917-455-1178
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Fax |
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Provider Business Mailing Address
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Address Line | 8009 CROSS ISLAND PKWY
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City | BELLEROSE
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State | NY
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Zip | 11426-1362
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Country | US
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Telephone | 917-455-1178
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 878829
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License Number State | NY
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