Provider Demographics
NPI:1346410214
Name:DELILLE, ELSA M (NP)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:M
Last Name:DELILLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELSA
Other - Middle Name:
Other - Last Name:PESTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1079
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1470 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6542
Practice Address - Country:US
Practice Address - Phone:212-241-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily