Provider Demographics
NPI:1679372379
Name:APPLETON, ELENA TARDANICO
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:TARDANICO
Last Name:APPLETON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 HERITAGE HLS UNIT B
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-1544
Mailing Address - Country:US
Mailing Address - Phone:646-498-9339
Mailing Address - Fax:
Practice Address - Street 1:72 HERITAGE HLS UNIT B
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-1544
Practice Address - Country:US
Practice Address - Phone:646-498-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121491-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical