Healthcare Provider Details

I. General information

NPI: 1689839755
Provider Name (Legal Business Name): ELENA NIKOLAI GINSBERG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 OLD POST RD STE 2G
BEDFORD NY
10506-1062
US

IV. Provider business mailing address

69 S BROADWAY
YONKERS NY
10701-4004
US

V. Phone/Fax

Practice location:
  • Phone: 914-234-8670
  • Fax: 914-964-1477
Mailing address:
  • Phone: 914-376-5555
  • Fax: 914-964-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: