Individual
MRS. JUDITH ELIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1052 E 81ST ST, BROOKLYN, NY 11236-4222
(718) 444-0172
Mailing address
1052 E 81ST ST, BROOKLYN, NY 11236-4222
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006061
NY
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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