Healthcare Provider Details

I. General information

NPI: 1063052389
Provider Name (Legal Business Name): ELANA DEUTSCHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELANA FLEKSHER

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 HUNGRY HARBOR RD
VALLEY STREAM NY
11581-3039
US

IV. Provider business mailing address

718 HUNGRY HARBOR RD
VALLEY STREAM NY
11581-3039
US

V. Phone/Fax

Practice location:
  • Phone: 917-349-6395
  • Fax:
Mailing address:
  • Phone: 917-349-6395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number344852
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: