=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992798037
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELANA KASTNER MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2005
-----------------------------------------------------
Last Update Date | 03/24/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 70 E SUNRISE HWY STE 515E
-----------------------------------------------------
City | VALLEY STREAM
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11581-1233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-536-5656
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 MINEOLA BLVD STE 100 WOMEN'S CONTEMPORARY CARE ASSOCIATES
-----------------------------------------------------
City | MINEOLA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11501-4073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-663-3010
-----------------------------------------------------
Fax | 516-663-3026
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 201986
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------