Healthcare Provider Details

I. General information

NPI: 1962560003
Provider Name (Legal Business Name): LLOYD K ELKOWITZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NORTHERN BLVD
GREAT NECK NY
11021-4309
US

IV. Provider business mailing address

107 NORTHERN BLVD
GREAT NECK NY
11021-4309
US

V. Phone/Fax

Practice location:
  • Phone: 516-829-3310
  • Fax: 516-829-3565
Mailing address:
  • Phone: 516-829-3310
  • Fax: 516-829-3565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22749
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21918
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: