Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 057440 | NY |
NPI | 1053571463 |
---|---|
Provider Name | Elisheva Aziza Rosenfeld |
First Address | New Hyde Park, NY 11042-2061 |
Second Address | New Hyde Park, NY 11042-2061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 02/06/2015 |