Provider Demographics
NPI:1497766448
Name:ELINA ATLAS
Entity Type:Organization
Organization Name:ELINA ATLAS
Other - Org Name:ATLAS AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:917-609-6194
Mailing Address - Street 1:2369 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6507
Mailing Address - Country:US
Mailing Address - Phone:917-609-6194
Mailing Address - Fax:
Practice Address - Street 1:3101 OCEAN PKWY
Practice Address - Street 2:SUITE 1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8440
Practice Address - Country:US
Practice Address - Phone:718-996-2260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0017631332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2619872Medicaid