Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 279565 | NY |
N | 207P00000X | Emergency Physician | E420229009739 | MI |
NPI | 1003173238 |
---|---|
Provider Name | Dr. Emin Elezi |
First Address | New York, NY 10037-1802 |
Second Address | New York, NY 10037-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 19/08/2015 |