Provider Demographics
NPI:1417270281
Name:JEAN-JACQUES, ELSY (LPN)
Entity Type:Individual
Prefix:
First Name:ELSY
Middle Name:
Last Name:JEAN-JACQUES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 KIME AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3316
Mailing Address - Country:US
Mailing Address - Phone:718-679-8918
Mailing Address - Fax:
Practice Address - Street 1:131 KIME AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3316
Practice Address - Country:US
Practice Address - Phone:718-679-8918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297018164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse