Provider Demographics
NPI:1699859132
Name:YATZKAN, ELAINE S (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:S
Last Name:YATZKAN
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 CENTRAL PARK WEST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3512
Mailing Address - Country:US
Mailing Address - Phone:212-724-6330
Mailing Address - Fax:212-724-6330
Practice Address - Street 1:262 CENTRAL PARK WEST
Practice Address - Street 2:
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10024-3512
Practice Address - Country:US
Practice Address - Phone:212-724-6330
Practice Address - Fax:212-724-6330
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO1237311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N21031Medicare ID - Type Unspecified