Provider Demographics
NPI:1649585076
Name:PEREIRA, ELENA (ACNP)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:LOBO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:75-59 263 STREET
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1306
Mailing Address - Country:US
Mailing Address - Phone:718-470-8306
Mailing Address - Fax:718-470-4678
Practice Address - Street 1:75-59 263 STREET
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1306
Practice Address - Country:US
Practice Address - Phone:718-470-8306
Practice Address - Fax:718-470-4678
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY440309163W00000X
NYF430318-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse