Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | J1083 | TX |
N | 2084N0400X | Neurologist | ME88890 | FL |
NPI | 1023091477 |
---|---|
Provider Name | Dr. Ezra Samuel Elkayam |
First Address | El Paso, TX 79902-3575 |
Second Address | El Paso, TX 79902-3575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 12/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09737392 | (05) | MS |
1541966 | (05) | LA |
269879000 | (05) | FL |
F72012 | (02) | FL |