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Individual

ELIZABETH HAILU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 ROUTE 59, STE 103A, SUFFERN, NY 10901-4927
(800) 207-5737
(610) 401-2100
Mailing address
153 W 11TH ST, NEW YORK, NY 10011-8305

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
237985
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02100461
NY
Enumeration date
06/29/2005
Last updated
07/08/2007
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