Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 189811 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 189811 | NY |
N | 207VX0000X | Obstetrician | 189811 | NY |
NPI | 1386645315 |
---|---|
Provider Name | Dr. Andrew Elimian |
First Address | Hawthorne, NY 10532 |
Second Address | Hawthorne, NY 10532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 14/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01739940 | (05) | NY |
G89599 | (02) | NY |