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General NPI Number Information
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NPI Number | 1699830380
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Entity Type | Organization
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Legal Business Name | ELAINE WILLIAMS PAULINE MD
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Dates
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Enumeration Date | 12/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 325 E 7TH ST
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City | BROOKLYN
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State | NY
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Zip | 11218-3313
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Country | US
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Telephone | 718-644-2495
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Fax |
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Provider Business Mailing Address
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Address Line | 325 E 7TH ST
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City | BROOKLYN
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State | NY
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Zip | 11218-3313
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Country | US
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Telephone | 718-644-2495
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ELAINE PAULINE
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Credential |
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Telephone | 718-644-2495
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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 | N005937
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License Number State | NY
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