Basic Information
| Provider Information | |||||||||
| NPI: | 1548279060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLOSTRI | ||||||||
| FirstName: | ELENI | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | N.P.P., APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 CUMMINGS CTR | ||||||||
| Address2: | SUITE 266T | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019156175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789211190 | ||||||||
| FaxNumber: | 9789273724 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 CUMMINGS CTR | ||||||||
| Address2: | SUITE 266T | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019156175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789211190 | ||||||||
| FaxNumber: | 9789273724 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 03/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | F400516 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 278827 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.