Provider Demographics
NPI:1760922611
Name:DENIS, ELAJAH (DNP, CRNA)
Entity type:Individual
Prefix:DR
First Name:ELAJAH
Middle Name:
Last Name:DENIS
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 LIBERTY AVE # 511
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2335
Mailing Address - Country:US
Mailing Address - Phone:516-673-8406
Mailing Address - Fax:
Practice Address - Street 1:388 MIDWOOD ST
Practice Address - Street 2:3I
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5449
Practice Address - Country:US
Practice Address - Phone:516-673-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-26
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY326335164W00000X
NY772660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse