Provider Demographics
NPI:1871074856
Name:ELKIN, CYDNEY ILANA (OTR/L)
Entity type:Individual
Prefix:
First Name:CYDNEY
Middle Name:ILANA
Last Name:ELKIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BEECHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-8103
Mailing Address - Country:US
Mailing Address - Phone:973-747-8224
Mailing Address - Fax:
Practice Address - Street 1:123 N UNION AVE STE 204A
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2198
Practice Address - Country:US
Practice Address - Phone:908-653-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00839500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist