Provider Demographics
NPI:1093495590
Name:FRANTELLIZZI, ELAINA (NP)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:FRANTELLIZZI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3548 35TH ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1604
Mailing Address - Country:US
Mailing Address - Phone:631-987-8555
Mailing Address - Fax:
Practice Address - Street 1:1790 BROADWAY STE 1802
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1471
Practice Address - Country:US
Practice Address - Phone:212-530-0624
Practice Address - Fax:212-867-4353
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF311403363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health