Provider Demographics
NPI:1639580301
Name:ZIKO, ELDA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELDA
Middle Name:
Last Name:ZIKO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BATHGATE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6021
Mailing Address - Country:US
Mailing Address - Phone:718-551-5719
Mailing Address - Fax:718-975-4337
Practice Address - Street 1:3055 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4857
Practice Address - Country:US
Practice Address - Phone:718-655-1000
Practice Address - Fax:718-975-8502
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584357363LF0000X
NYF40356601363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily