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NPI Code Detail

MEDICARE: ELENA BURTON

MEDICARE:   ELENA  BURTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health Counselor015395NY

General Provider Information

NPI Number : 1760150080
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA BURTON
Provider Business Mailing Address
First Line : 932 AMSTERDAM AVE APT 3N
Second Line :
City : NEW YORK
State : NY
Zip : 10025-3677
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 928 BROADWAY STE 803
Second Line :
City : NEW YORK
State : NY
Zip : 10010-8125
Country : US
Telephone Number : 610-659-1023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2021
Last Update Date : 03/11/2025

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Directions to “ ELENA BURTON ” Practice Location

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