Provider Demographics
NPI:1679093181
Name:TOLAN, ELAINE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:TOLAN
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 1:501 6TH ST STE 1J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3671
Mailing Address - Country:US
Mailing Address - Phone:718-780-3070
Mailing Address - Fax:718-246-8611
Practice Address - Street 1:501 6TH ST STE 1J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3671
Practice Address - Country:US
Practice Address - Phone:718-780-3070
Practice Address - Fax:718-246-8611
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY717867163W00000X
NYF342682-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse