Han, Elisa

Han, Elisa is an individual health care provider with primary practice located at 5 Medical Dr , Port Jefferson Station NY 11776-1595. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Han, Elisa can be contacted via phone (631) 632-3785.

Contact Information

Primary practice address
5 Medical Dr Port Jefferson Station NY 11776-1595
Phone: (631) 632-3785
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 012228 New York

Profile Details

NPI number 1578506051
LBN Legal business name Han, Elisa
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578506051 NPPES
New York Other 7606588 AETNA
New York MEDICAID 01992589 AETNA

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