Provider Demographics
NPI:1497148076
Name:ELTING, SYVAN (MS)
Entity Type:Individual
Prefix:
First Name:SYVAN
Middle Name:
Last Name:ELTING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SYVAN
Other - Middle Name:JOY
Other - Last Name:TEPERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 CHESTNUT WAY
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3831
Mailing Address - Country:US
Mailing Address - Phone:267-679-7255
Mailing Address - Fax:
Practice Address - Street 1:37 CHESTNUT WAY
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3831
Practice Address - Country:US
Practice Address - Phone:267-679-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002669103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst