Provider Demographics
NPI:1740651363
Name:ZAMFT, ELYSHA DANIELLE (MS)
Entity type:Individual
Prefix:MRS
First Name:ELYSHA
Middle Name:DANIELLE
Last Name:ZAMFT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14452 72ND RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2406
Mailing Address - Country:US
Mailing Address - Phone:718-268-0793
Mailing Address - Fax:
Practice Address - Street 1:14452 72ND RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2406
Practice Address - Country:US
Practice Address - Phone:718-268-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1408017103K00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst