Provider Demographics
NPI:1689068017
Name:ELKIN, JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ELKIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 N CENTRAL AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 N CENTRAL AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1903
Practice Address - Country:US
Practice Address - Phone:914-629-4680
Practice Address - Fax:914-683-6442
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001493171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist