Individual
DR. ELAINE ELYSHIA PASS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 BROADWAY, FLOOR 1, BROOKLYN, NY 11206-7305
(718) 599-0477
(718) 599-8677
Mailing address
101 W 12TH ST, 12W, NEW YORK, NY 10011-8142
(718) 599-0477
(718) 599-8677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
097408
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00164049
—
NY
Enumeration date
11/25/2005
Last updated
07/08/2007
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