Provider Demographics
NPI:1063674067
Name:ELINSKI, MICHAEL J
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:ELINSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:JOSEPH
Other - Last Name:ELINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:23 DOMINY LN
Mailing Address - Street 2:PO BOX 2255
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-0296
Mailing Address - Country:US
Mailing Address - Phone:631-324-1505
Mailing Address - Fax:
Practice Address - Street 1:23 DOMINY LN
Practice Address - Street 2:BEHIND 19 CEDAR ST
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-0296
Practice Address - Country:US
Practice Address - Phone:631-324-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1504092084P0800X
CAG534242084P0800X
FLME602682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY150409OtherNY STATE LICENSE
NY008587640Medicaid
FLME60268OtherLICENSE NUMBER
CAG53424OtherLICENSE NUMBER
CAG53424OtherLICENSE NUMBER
NY008587640Medicaid
46D33100Medicare PIN