Provider Demographics
NPI:1154882264
Name:NAWY, ELANA C (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:C
Last Name:NAWY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:M
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:997 STAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2109
Mailing Address - Country:US
Mailing Address - Phone:718-948-1900
Mailing Address - Fax:
Practice Address - Street 1:997 STAFFORD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2109
Practice Address - Country:US
Practice Address - Phone:718-948-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008505-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty