Healthcare Provider Details

I. General information

NPI: 1023236916
Provider Name (Legal Business Name): ELIZABETH W MAALOUF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 LAWRENCE ST
MT KISCO NY
10549
US

IV. Provider business mailing address

32 BURNS PLACE
BRIARCLIFF MANOR NY
10510
US

V. Phone/Fax

Practice location:
  • Phone: 914-864-2399
  • Fax:
Mailing address:
  • Phone: 914-762-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number3061371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: