Basic Information
| Provider Information | |||||||||
| NPI: | 1447415765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PE | ||||||||
| FirstName: | ELENA | ||||||||
| MiddleName: | M DELA CRUZ | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE GUSTAVE LEVY PLACE #1054 | ||||||||
| Address2: | MOUNT SINAI MEDICAL CENTER | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122417272 | ||||||||
| FaxNumber: | 2125342776 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE GUSTAVE LEVY PLACE #1054 | ||||||||
| Address2: | MOUNT SINAI MEDICAL CENTER | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122417272 | ||||||||
| FaxNumber: | 2125342776 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2008 | ||||||||
| LastUpdateDate: | 07/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP2201X | F301372-1 | NY | Y | Nursing Service Providers | Registered Nurse | Ambulatory Care |
No ID Information.