Provider Demographics
NPI:1265137772
Name:ELEPHANT HEALTH SERVICES - NURSE PRACTITIONER IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ELEPHANT HEALTH SERVICES - NURSE PRACTITIONER IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIPPE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-231-2461
Mailing Address - Street 1:2700 HERING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5321
Mailing Address - Country:US
Mailing Address - Phone:718-231-2461
Mailing Address - Fax:
Practice Address - Street 1:2700 HERING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5321
Practice Address - Country:US
Practice Address - Phone:718-231-2461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty