Provider Demographics
NPI:1003506288
Name:ELESON, JILL (CHHC, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:ELESON
Suffix:
Gender:F
Credentials:CHHC, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E 76TH ST APT 8F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2831
Mailing Address - Country:US
Mailing Address - Phone:434-248-7508
Mailing Address - Fax:213-340-5870
Practice Address - Street 1:386 PARK AVE SOUTH,
Practice Address - Street 2:FL 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8815
Practice Address - Country:US
Practice Address - Phone:434-248-7508
Practice Address - Fax:213-340-5870
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach