Individual
ELIZABETH ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
(718) 991-4516
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
(718) 991-4516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
279974
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279974
LICENSE
NY
Enumeration date
12/30/2014
Last updated
07/17/2015
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