Healthcare Provider Details
I. General information
NPI: 1790950012
Provider Name (Legal Business Name): ELIF DOKMECI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/28/2008
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 CEDAR ST
NEW HAVEN CT
06510-3218
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-250-9095
- Fax: 203-737-6035
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | 15710R |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | MD2012-0044 |
| License Number State | NM |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | 042557 |
| License Number State | CT |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | 042557 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: