Individual
DR. ELENA DIMICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6000
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5506
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021026394
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
07/15/2021
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