Kelsey Waisanen

NPI #1154084580 in Miller Place, New York

Provider Information

NPI Number: 1154084580
Entity Type: Individual
Name: Kelsey Waisanen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Oct 21, 2021
Last Updated: Aug 8, 2023

Practice Location

Address: 111 SYLVAN AVE
City: Miller Place
State: New York
ZIP Code: 11764-2420
Phone: (631) 928-4888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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