Provider Demographics
NPI:1376844191
Name:EARLINGTON, ELAINE D (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:D
Last Name:EARLINGTON
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ANDOVER ROAD
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530
Mailing Address - Country:US
Mailing Address - Phone:212-420-2788
Mailing Address - Fax:
Practice Address - Street 1:1ST AVE AT 16TH ST
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003803363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant