Individual
STEVEN J ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4411
Mailing address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD28371
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246516
—
OR
05
—
8534158
—
WA
Enumeration date
08/22/2008
Last updated
08/15/2012
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