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General NPI Number Information
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NPI Number | 1649477613
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Entity Type | Individual
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Provider Name | DR. JENNA ELIAS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 261 5TH AVE RM 901
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City | NEW YORK
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State | NY
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Zip | 10016-7601
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Country | US
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Telephone | 201-341-1892
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Fax |
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Provider Business Mailing Address
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Address Line | 545 W END AVE APT 5F
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City | NEW YORK
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State | NY
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Zip | 10024-2713
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Country | US
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Telephone | 201-341-1892
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 002111-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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