Provider Demographics
NPI:1568623692
Name:FRANZITTA, ELAINE F
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:F
Last Name:FRANZITTA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:F
Other - Last Name:PELLICIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1406 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:N MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1729
Mailing Address - Country:US
Mailing Address - Phone:516-379-6372
Mailing Address - Fax:
Practice Address - Street 1:64 ROUTE 109
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6208
Practice Address - Country:US
Practice Address - Phone:631-587-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02721002Medicaid