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General NPI Number Information
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NPI Number | 1275587024
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Entity Type | Individual
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Provider Name | STEVEN MARC ELIAS MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 350 ENGLE ST
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1808
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Country | US
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Telephone | 212-342-4749
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Fax | 201-816-8812
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Provider Business Mailing Address
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Address Line | PO BOX 27036
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City | NEW YORK
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State | NY
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Zip | 10087-7036
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Country | US
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Telephone | 212-342-4749
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Fax | 201-816-8812
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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 | 44570
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MA44570
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 1452341
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License Number State | NY
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