Provider Demographics
NPI:1386114916
Name:DEGREZIA, ELAINA
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:DEGREZIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 EAST 54TH STREET 14Q
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:917-596-6229
Mailing Address - Fax:
Practice Address - Street 1:450 FASHION AVENUE #408
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10123
Practice Address - Country:US
Practice Address - Phone:212-279-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist