Provider Demographics
NPI:1306162482
Name:DE LA HOZ, ELAINE (NP)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DE LA HOZ
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 1:6601 GRANTON AVE
Mailing Address - Street 2:APT B5
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-3522
Mailing Address - Country:US
Mailing Address - Phone:201-766-4765
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:HCC 3D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-3643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430506-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care