Provider Demographics
NPI:1407476872
Name:CAMERA, ELIZABETH P
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:P
Last Name:CAMERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S BAY AVE
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-4411
Mailing Address - Country:US
Mailing Address - Phone:631-704-3216
Mailing Address - Fax:
Practice Address - Street 1:214 S BAY AVE
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-4411
Practice Address - Country:US
Practice Address - Phone:631-704-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst