Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 2069012 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 25MA07002700 | NJ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 2069012 | NY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 25MA07002700 | NJ |
NPI | 1952478729 |
---|---|
Provider Name | Mr. Marc Jeffrey Elkowitz |
First Address | Great Neck, NY 11021 |
Second Address | Great Neck, NY 11021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12235 | (02) |