Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JOHANNA KRISTIN ELLERUP, PHARMD
ActivePharmacist Clinician (PhC) · NORTH MASSAPEQUA, NY
Registration Details
- NPI Number
- 1497957690
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 1, 2007 (18.89971622241 yrs)
- Last Updated
- May 12, 2011
- Licenses
-
079733 (NY)055468 (NY)
Practice Information
- Address
-
99 N MAPLE STNORTH MASSAPEQUA, NY, 117582636Browse NY providers · Browse ZIP 11758
- Phone
- 5165098185
- Fax
- 5167998286
- Primary Specialty
-
Pharmacist Clinician (PhC)
1835P0018X
- Additional Specialty
- Pharmacist Clinician (PhC)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.