Basic Information
Provider Information
NPI: 1336717941
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KURLANDER
FirstName: ELANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 54 PHIPPS LN
Address2:  
City: PLAINVIEW
State: NY
PostalCode: 118031948
CountryCode: US
TelephoneNumber: 5168135931
FaxNumber:  
Practice Location
Address1: 4071 LEE RD STE 260
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441282173
CountryCode: US
TelephoneNumber: 2168616200
FaxNumber: 2163637490
Other Information
ProviderEnumerationDate: 06/11/2021
LastUpdateDate: 06/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001XRES.004382OHY Dental ProvidersDentistGeneral Practice

No ID Information.


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