Healthcare Provider Details

I. General information

NPI: 1326493487
Provider Name (Legal Business Name): ELIZABETH STONE M.D./PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W 168TH ST
NEW YORK NY
10032-3725
US

IV. Provider business mailing address

5 HIGHLAND WAY
SCARSDALE NY
10583-1648
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5697
  • Fax:
Mailing address:
  • Phone: 610-220-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberS-20-037
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number295798-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number295798-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: