Kathleen Fanelli
Kathleen Fanelli is a Nurse Practitioner in Port Jefferson, New York. Qualified in 2024, 2 years ago. Practices with John T Mather Memorial Hospital, a 180-clinician group and accepts Medicare assignment. Licensed in New York.
- Years since qualifying
- 2
- Licensed in
- NY
- In the registry since
- 2024
Practice location Address checks out
75 N Country RdPort Jefferson, NY 11777-2119
Phone: (631) 473-1320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Acute Care Nurse Practitioner (primary) | Taxonomy 363LA2100X · Licence F433058-01 (NY) |
|---|
Record details
| NPI number | 1023833977 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | November 16, 2024 |
| Last updated in NPPES | March 20, 2025 |
| Certification date | March 20, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Group practice | John T Mather Memorial Hospital — 180 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |