Individual
ELSIE SAM-ERVILUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-7576
(212) 746-8383
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-9375
(212) 746-8383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363A00000X003653
NY
Other
Enumeration date
02/12/2007
Last updated
04/07/2020
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