Healthcare Provider Details

I. General information

NPI: 1851126452
Provider Name (Legal Business Name): ELENA HUSKO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W COLLINGS AVE
COLLINGSWOOD NJ
08108-3017
US

IV. Provider business mailing address

300 W COLLINGS AVE
COLLINGSWOOD NJ
08108-3017
US

V. Phone/Fax

Practice location:
  • Phone: 201-213-7960
  • Fax:
Mailing address:
  • Phone: 201-213-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35SI00740400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS018997
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: