Healthcare Provider Details

I. General information

NPI: 1831985142
Provider Name (Legal Business Name): ELANA SHPUNT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MADISON AVE STE 1301
NEW YORK NY
10022-1088
US

IV. Provider business mailing address

635 MADISON AVE STE 1301
NEW YORK NY
10022-1088
US

V. Phone/Fax

Practice location:
  • Phone: 212-715-0888
  • Fax:
Mailing address:
  • Phone: 212-715-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: