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General NPI Number Information
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NPI Number | 1326774415
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Entity Type | Individual
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Provider Name | TAYLOR ELIZABETH MUCCI
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1908 E FRANKLIN BLVD STE 100
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City | GASTONIA
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State | NC
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Zip | 28054-4742
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Country | US
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Telephone | 704-271-1215
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Fax | 704-271-9875
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Provider Business Mailing Address
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Address Line | 216 WIDGEDON LNDG
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City | HILTON
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State | NY
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Zip | 14468-8955
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 028604
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License Number State | NY
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