Provider Demographics
NPI:1225648504
Name:ZUHOSKI, ELISA (RN)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:ZUHOSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:FUKUDA LUCAR DE ZUHOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:954 GARDINER DR
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7636
Mailing Address - Country:US
Mailing Address - Phone:631-559-6034
Mailing Address - Fax:
Practice Address - Street 1:954 GARDINER DR
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7636
Practice Address - Country:US
Practice Address - Phone:631-559-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY794908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse