Healthcare Provider Details

I. General information

NPI: 1275464653
Provider Name (Legal Business Name): ELYSIAN MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 MAPLE AVE FL 8
WHITE PLAINS NY
10601-4706
US

IV. Provider business mailing address

66 TANGLEWYLDE AVE
BRONXVILLE NY
10708-3110
US

V. Phone/Fax

Practice location:
  • Phone: 914-626-2663
  • Fax: 347-428-0196
Mailing address:
  • Phone: 914-626-2663
  • Fax: 347-428-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number State

VIII. Authorized Official

Name: MILAN KUMAR SEN
Title or Position: MEMBER MANAGER
Credential: MD
Phone: 212-390-1696