Healthcare Provider Details

I. General information

NPI: 1932324662
Provider Name (Legal Business Name): ELIZABETH A CAHN NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248W108ST
NEW YORK NY
10025
US

IV. Provider business mailing address

530E85ST
NEW YORK NY
10028
US

V. Phone/Fax

Practice location:
  • Phone: 212-663-3000
  • Fax: 212-663-3179
Mailing address:
  • Phone: 212-734-8869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400590
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: