Provider Demographics
NPI:1790823862
Name:AUBREY, ELANA R
Entity Type:Individual
Prefix:MS
First Name:ELANA
Middle Name:R
Last Name:AUBREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 CHESTER AVE
Mailing Address - Street 2:APT. 2R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2002
Mailing Address - Country:US
Mailing Address - Phone:718-851-0389
Mailing Address - Fax:
Practice Address - Street 1:1743 81ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2268
Practice Address - Country:US
Practice Address - Phone:718-256-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720663491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical