Healthcare Provider Details

I. General information

NPI: 1649356486
Provider Name (Legal Business Name): ANDREW J ELLIOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 E 72ND ST 5TH FLOOR
NEW YORK NY
10021-4099
US

IV. Provider business mailing address

523 E 72ND ST 5TH FLOOR
NEW YORK NY
10021-4099
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1579
  • Fax:
Mailing address:
  • Phone: 212-606-1579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number202416
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number202416
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number202416
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number202416
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number202416
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number202416
License Number StateNY
# 7
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number202416
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: