| Doctor Name: | ELAYNE J. KING |
| NPI Number: | 1073672945 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 009160-1 |
| Business Practice Address: | 7 Watersedge Way Port Jefferson, NY - 117771435 |
| Business Phone Number: | 6313313552 |
| Business Fax Number: | |
| Mailing Address: | 7 Watersedge Way, PORT JEFFERSON |
| State: | NY |
| Postal Code: | 117771435 |
| Phone Number: | 6313313552 |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0700X |
| License Number: | 009160-1 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Adult Development & Aging |
| Taxonomy Definition: | |