Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 134689 | NY |
N | 207PE0004X | Emergency Medical Services | 134689-1 | NY |
NPI | 1164436101 |
---|---|
Provider Name | Scott T Elberger |
First Address | Uniondale, NY 11556-1301 |
Second Address | Merrick, NY 11566-4643 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 20/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2132070 | (05) | NY |
F50590 | (02) | NY |