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General NPI Number Information
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NPI Number | 1881236925
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Entity Type | Individual
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Provider Name | WHITNEY ELIZABETH VAUGHN PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 100 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 45 WYCKOFF ST APT 2
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City | BROOKLYN
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State | NY
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Zip | 11201-6304
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Country | US
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Telephone | 585-789-0449
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 024231
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License Number State | NY
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