Individual
ELISABETH DIMITRATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
530 1ST AVE STE 9V, NEW YORK, NY 10016-6402
(212) 263-0702
Mailing address
37 MEADOW WOODS RD, GREAT NECK, NY 11020-1324
(516) 790-0700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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