Provider Demographics
NPI:1003280900
Name:RAJESH, ELSEY (AG- ACNP-BC)
Entity Type:Individual
Prefix:
First Name:ELSEY
Middle Name:
Last Name:RAJESH
Suffix:
Gender:F
Credentials:AG- ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FERMI CT
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1335
Mailing Address - Country:US
Mailing Address - Phone:914-402-5371
Mailing Address - Fax:
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-734-3600
Practice Address - Fax:914-734-3601
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430916-1363LA2100X
NY430916363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care