Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 284945 | NY |
NPI | 1447518857 |
---|---|
Provider Name | Elizabeth Mia Floyd |
First Address | Great Neck, NY 11021-5200 |
Second Address | Great Neck, NY 11021-5200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 22/01/2019 |