Individual
RONALD S. ELBAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5645 MAIN ST, 4TH FLOOR, FLUSHING, NY 11355-5045
(718) 670-2558
(718) 670-1585
Mailing address
5645 MAIN ST, 4TH FLOOR, FLUSHING, NY 11355-5045
(718) 670-2558
(718) 670-1585
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008042-1
NY
363AM0700X
Medical Physician Assistant
Primary
004257
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913135016
—
GA
Enumeration date
02/22/2006
Last updated
01/31/2024
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