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Individual
ELLEN D. WAITZKIN
Active
Individual
ELLEN D. WAITZKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
12207
NH
174400000X
Specialist
57349
MA
174400000X
Specialist
Primary
60 250982
NY
Other
Enumeration date
06/01/2006
Last updated
01/22/2009
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