Healthcare Provider Details

I. General information

NPI: 1316187198
Provider Name (Legal Business Name): ELENA BETH HULL MFT, CAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 MADISON AVE STE. 708
NEW YORK NY
10016-1001
US

IV. Provider business mailing address

271 MADISON AVE STE. 708
NEW YORK NY
10016-1001
US

V. Phone/Fax

Practice location:
  • Phone: 212-696-6452
  • Fax:
Mailing address:
  • Phone: 212-696-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000341-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: