Healthcare Provider Details

I. General information

NPI: 1558447821
Provider Name (Legal Business Name): ELIZABETH M ALDERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHAM 3415 BAINBRIDGE AVENUE
BRONX NY
10467
US

IV. Provider business mailing address

116 HILLANDALE DR
NEW ROCHELLE NY
10804-1907
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-2450
  • Fax:
Mailing address:
  • Phone: 718-741-2450
  • Fax: 718-944-5862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number176809
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number176809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: