Individual
MS. IRENA ELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
618 AWOSTING RD, PINE BUSH, NY 12566-5570
(845) 744-5539
Mailing address
618 AWOSTING RD, PINE BUSH, NY 12566-5570
(845) 744-5539
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
246671-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01474684
—
NY
Enumeration date
07/23/2007
Last updated
07/23/2007
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