Basic Information
Provider Information
NPI: 1336458058
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELBRECHT
FirstName: ELAINE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 336-99TH STREET
Address2: #14
City: BROOKLYN
State: NY
PostalCode: 11209
CountryCode: US
TelephoneNumber: 7182380766
FaxNumber: 7182342314
Practice Location
Address1: 8620 18TH AVE
Address2: SECOND FLOOR
City: BROOKLYN
State: NY
PostalCode: 112143702
CountryCode: US
TelephoneNumber: 7182568818
FaxNumber: 7182342314
Other Information
ProviderEnumerationDate: 09/29/2010
LastUpdateDate: 09/29/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X3079631NYY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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