Provider Demographics
NPI:1508951724
Name:AYLLON, ELSA M (RN CDOE)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:M
Last Name:AYLLON
Suffix:
Gender:F
Credentials:RN CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGH SERVICE AVENUE
Mailing Address - Street 2:ATTN ROSE SOARES 4TH FL MARIAN HALL
Mailing Address - City:N PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-456-3649
Mailing Address - Fax:401-456-4250
Practice Address - Street 1:21 PEACE ST
Practice Address - Street 2:ST JOSEPH HOSPITAL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907
Practice Address - Country:US
Practice Address - Phone:401-456-4416
Practice Address - Fax:401-456-4250
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN33580163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator