Provider Demographics
NPI:1639449507
Name:ELOI, SHIRLEY A (RN)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:ELOI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 SAINT GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-2000
Mailing Address - Country:US
Mailing Address - Phone:718-791-0824
Mailing Address - Fax:
Practice Address - Street 1:24526 147TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2420
Practice Address - Country:US
Practice Address - Phone:718-791-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY627962163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY627962OtherNEW YORK STATE OFFICE OF THE PROFESSIONS