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General NPI Number Information
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NPI Number | 1043714603
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Entity Type | Organization
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Legal Business Name | A ELASSAR MEDICAL PRACTICE P.C
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 693 5TH AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10022-3164
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Country | US
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Telephone | 800-853-7595
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Fax | 800-780-6167
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Provider Business Mailing Address
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Address Line | 693 5TH AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10022-3164
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Country | US
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Telephone | 800-853-7595
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Fax | 800-780-6167
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. ALYAA ELASSAR
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Credential | MD
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Telephone | 800-853-7595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 263089-1
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License Number State | NY
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