Healthcare Provider Details

I. General information

NPI: 1134054141
Provider Name (Legal Business Name): ELIA DENNY DE LOS SANTOS FNP-C ,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 HAMILTON PL
NEW YORK NY
10031-6885
US

IV. Provider business mailing address

19 HAMILTON PL
NEW YORK NY
10031-6885
US

V. Phone/Fax

Practice location:
  • Phone: 212-234-0800
  • Fax: 212-234-2223
Mailing address:
  • Phone: 203-721-2569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360492
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: