Healthcare Provider Details

I. General information

NPI: 1578968764
Provider Name (Legal Business Name): ELENA GINSBERG FAMILY HEALTH NP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 JEUNGST RD
CROTON FALLS NY
10519
US

IV. Provider business mailing address

48 SUMNER RD
GREENWICH CT
06831-2720
US

V. Phone/Fax

Practice location:
  • Phone: 203-561-0675
  • Fax: 203-869-9669
Mailing address:
  • Phone: 203-561-0675
  • Fax: 203-869-9669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number33 106795
License Number StateNY

VIII. Authorized Official

Name: ELENA GINSBERG
Title or Position: OWNER
Credential: FNP
Phone: 203-561-0675