Provider Demographics
NPI:1285077990
Name:SCAVONE, ELISA J (MS, CGC)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:J
Last Name:SCAVONE
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 EASTCHESTER RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2375
Mailing Address - Country:US
Mailing Address - Phone:718-405-8150
Mailing Address - Fax:718-405-8154
Practice Address - Street 1:1695 EASTCHESTER RD STE 301
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2375
Practice Address - Country:US
Practice Address - Phone:718-405-8150
Practice Address - Fax:718-405-8154
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS