Provider Demographics
NPI:1952629081
Name:TURSI-DESTEFANO, ELSA ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELSA
Middle Name:ELIZABETH
Last Name:TURSI-DESTEFANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2184 MEROKEE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566
Mailing Address - Country:US
Mailing Address - Phone:516-377-1306
Mailing Address - Fax:516-377-1306
Practice Address - Street 1:2184 MEROKEE DRIVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-377-1306
Practice Address - Fax:516-377-1306
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322492-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse