Healthcare Provider Details

I. General information

NPI: 1508222472
Provider Name (Legal Business Name): ELANA LUBIANKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELANA WIESEL PA

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 FELTER AVE
HEWLETT NY
11557-1132
US

IV. Provider business mailing address

338 FELTER AVE
HEWLETT NY
11557-1132
US

V. Phone/Fax

Practice location:
  • Phone: 516-489-8768
  • Fax:
Mailing address:
  • Phone: 516-489-8768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number019392
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: