MEDICARE: ELAINE WILLIAMS PAULINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	N005937	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699830380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELAINE WILLIAMS PAULINE MD

Provider Business Mailing Address
First Line	:	325 E 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3313
Country	:	US
Telephone Number	:	718-644-2495
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 E 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3313
Country	:	US
Telephone Number	:	718-644-2495
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	ELAINE PAULINE
Credential	:
Telephone Number	:	718-644-2495

Provider Enumeration Date	:	12/25/2006
Last Update Date	:	08/22/2020

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