| Ocean Wounds VA PLLC | |
|
200 W Constance Rd Suffolk VA 23434-4413 | |
| (718) 408-8860 | |
| Not Available |
| Full Name | Ocean Wounds VA PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 W Constance Rd, Suffolk, Virginia |
| Authorized Official Name and Position | Elysse Lerner (SOLE OWNER) |
| Authorized Official Contact | 8459017289 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Wounds VA PLLC 144 Coles Way Lakewood NJ 08701-4885 | Ocean Wounds VA PLLC 200 W Constance Rd Suffolk VA 23434-4413 Ph: (718) 408-8860 |
| NPI Number | 1225991706 |
|---|---|
| Provider Enumeration Date | 12/03/2025 |
| Last Update Date | 12/03/2025 |
| Certification Date | 12/03/2025 |
| Medicare PECOS PAC ID | 6406332691 |
|---|---|
| Medicare Enrollment ID | O20260107003212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225991706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Katrina Jean Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346803343 PECOS PAC ID: 8820320005 Enrollment ID: I20191022001392 |
| Provider Name | Elysse Lerner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912373721 PECOS PAC ID: 3779867395 Enrollment ID: I20260114003593 |
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