Provider Demographics
NPI:1952143752
Name:ELKERSON, SYNCHANA
Entity type:Individual
Prefix:
First Name:SYNCHANA
Middle Name:
Last Name:ELKERSON
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 1:560 MALCOLM X BLVD APT 4F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1750
Mailing Address - Country:US
Mailing Address - Phone:929-434-6214
Mailing Address - Fax:
Practice Address - Street 1:560 MALCOLM X BLVD APT 4F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1750
Practice Address - Country:US
Practice Address - Phone:929-434-6214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health