Individual
ELANA SHALOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7064 YELLOWSTONE BLVD, FOREST HILLS, NY 11375-3563
(718) 355-9962
Mailing address
7064 YELLOWSTONE BLVD, FOREST HILLS, NY 11375-3563
(718) 355-9962
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017888
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017888
—
NY
Enumeration date
08/21/2014
Last updated
11/08/2016
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