Individual
DR. ELISEO A GO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8708 JUSTICE AVE, SUITE 1J, ELMHURST, NY 11373-4575
(917) 476-4952
(718) 901-6356
Mailing address
8708 JUSTICE AVE, SUITE 1J, ELMHURST, NY 11373-4575
(917) 476-4952
(718) 901-6356
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
190043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01640977
—
NY
01
—
190043
MEDICAL LICENSE
NY
Enumeration date
10/03/2006
Last updated
07/08/2007
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