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General NPI Number Information
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NPI Number | 1144764168
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Entity Type | Individual
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Provider Name | JAYNE ELIACH RN, MS CERTIFIED CLI
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Gender | Female
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Dates
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Enumeration Date | 12/09/2016
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 470 WEST END AVENUE SUITE 1D
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City | NY
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State | NY
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Zip | 10024
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Country | US
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Telephone | 212-721-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 470 WEST END AVENUE SUITE 1D
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City | NY
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State | NY
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Zip | 10024
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Country | US
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Telephone | 212-721-7211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 297325
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 297325
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 364SP0810X
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Taxonomy Name | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 297325
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License Number State | NY
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