Provider Demographics
NPI:1093514507
Name:ELSANABARY, HAYDY
Entity type:Individual
Prefix:
First Name:HAYDY
Middle Name:
Last Name:ELSANABARY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7872 82ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7600
Mailing Address - Country:US
Mailing Address - Phone:917-459-4109
Mailing Address - Fax:
Practice Address - Street 1:7872 82ND ST FL 2
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7600
Practice Address - Country:US
Practice Address - Phone:917-459-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010442171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter