Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 36876 | AZ |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 36876 | AZ |
NPI | 1205027133 |
---|---|
Provider Name | Ellie Zara Ley |
First Address | Scottsdale, AZ 85253-3694 |
Second Address | Scottsdale, AZ 85253-3694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 21/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
701121 | AHCCCS (01) | AZ |
U000069637 | (02) | UT |