Healthcare Provider Details

I. General information

NPI: 1801259502
Provider Name (Legal Business Name): ELIZABETH CHRISTINE CAUL RN, MSN, DHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 RYER AVE APARTMENT 2E
BRONX NY
10458-7011
US

IV. Provider business mailing address

2356 RYER AVE APARTMENT 2E
BRONX NY
10458-7011
US

V. Phone/Fax

Practice location:
  • Phone: 917-863-2868
  • Fax:
Mailing address:
  • Phone: 917-863-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number674520
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: