Provider Demographics
NPI:1194822924
Name:KLAJBOR, ELAINE A (NP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:A
Last Name:KLAJBOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 LEHIGH STATION RD
Mailing Address - Street 2:NINTH GRADE ACADEMY
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9620
Mailing Address - Country:US
Mailing Address - Phone:585-359-5560
Mailing Address - Fax:585-359-5563
Practice Address - Street 1:2000 LEHIGH STATION RD
Practice Address - Street 2:NINTH GRADE ACADEMY
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9620
Practice Address - Country:US
Practice Address - Phone:585-359-5560
Practice Address - Fax:585-359-5563
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380085363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics