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General NPI Number Information
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NPI Number | 1164643490
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Entity Type | Individual
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Provider Name | ELIE JOSEPH EL-CHARABATY MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 470 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3401
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Country | US
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Telephone | 718-987-5940
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Fax | 718-667-9708
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Provider Business Mailing Address
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Address Line | 97 NEW DORP LN SUITE A
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2364
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Country | US
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Telephone | 718-876-6220
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Fax | 718-876-5969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 251562
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License Number State | NY
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