Provider Demographics
NPI:1487136594
Name:ELENSA FAMILY HEALTHCARE LLC.
Entity type:Organization
Organization Name:ELENSA FAMILY HEALTHCARE LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SABIDO
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:201-841-2472
Mailing Address - Street 1:402 MORSETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-3204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5240
Practice Address - Country:US
Practice Address - Phone:973-594-0808
Practice Address - Fax:973-594-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center