Provider Demographics
NPI:1013310275
Name:DRUCKER, ELAINE (LMT)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 721
Mailing Address - Street 2:200 UNION ST
Mailing Address - City:GLASCO
Mailing Address - State:NY
Mailing Address - Zip Code:12432
Mailing Address - Country:US
Mailing Address - Phone:845-430-5149
Mailing Address - Fax:
Practice Address - Street 1:200 UNION ST
Practice Address - Street 2:
Practice Address - City:GLASCO
Practice Address - State:NY
Practice Address - Zip Code:12432
Practice Address - Country:US
Practice Address - Phone:845-430-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist