Individual
DIANA ELISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9732 63RD RD, REGO PARK, NY 11374-1639
(718) 275-2224
Mailing address
9707 63RD RD, APT 5D, REGO PARK, NY 11374-1607
(917) 609-3952
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
249712
NY
Other
Enumeration date
09/20/2007
Last updated
01/29/2016
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