Provider Demographics
NPI:1497212096
Name:EPSTEIN, ELKA
Entity Type:Individual
Prefix:
First Name:ELKA
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 AYCRIGG AVE APT 2J
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4731
Mailing Address - Country:US
Mailing Address - Phone:973-934-7434
Mailing Address - Fax:
Practice Address - Street 1:215 AYCRIGG AVE APT 2J
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4731
Practice Address - Country:US
Practice Address - Phone:973-934-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program