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General NPI Number Information
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NPI Number | 1679118392
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Entity Type | Organization
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Legal Business Name | IGOR ELMAN PHYSICIAN PC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 7 MEDICAL PARK DR # C
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City | POMONA
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State | NY
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Zip | 10970-3562
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Country | US
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Telephone | 845-362-1169
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Fax | 845-362-0111
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Provider Business Mailing Address
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Address Line | 7 MEDICAL PARK DR # C
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City | POMONA
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State | NY
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Zip | 10970-3562
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Country | US
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Telephone | 845-362-1169
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Fax | 845-362-0111
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | IGOR ELMAN
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Credential | DO
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Telephone | 917-607-4265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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