Provider Demographics
NPI:1053081109
Name:FRANCIS, ELIJAH (CNA)
Entity Type:Individual
Prefix:MR
First Name:ELIJAH
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 E 29TH ST APT 1S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1956
Mailing Address - Country:US
Mailing Address - Phone:646-469-5392
Mailing Address - Fax:
Practice Address - Street 1:2440 E 29TH ST APT 1S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1956
Practice Address - Country:US
Practice Address - Phone:646-469-5392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY000440647E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty