Provider Demographics
NPI:1023723012
Name:ELKHAULY, NORHAN
Entity type:Individual
Prefix:
First Name:NORHAN
Middle Name:
Last Name:ELKHAULY
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 1:1461 SHORE PKWY APT 5E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6130
Mailing Address - Country:US
Mailing Address - Phone:917-995-1039
Mailing Address - Fax:
Practice Address - Street 1:2825 3RD AVE STE 402
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4073
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:212-977-1057
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health