Provider Demographics
NPI:1487064424
Name:ELEBIARY, YEON JOUNG (FNP)
Entity type:Individual
Prefix:
First Name:YEON
Middle Name:JOUNG
Last Name:ELEBIARY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ORCHID LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1917
Mailing Address - Country:US
Mailing Address - Phone:646-417-4905
Mailing Address - Fax:
Practice Address - Street 1:46 BRENTWOOD RD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6924
Practice Address - Country:US
Practice Address - Phone:631-647-3800
Practice Address - Fax:631-968-3749
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY592766163WM0705X
NYF338581-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical