Individual
DR. ELIZABETH G DEMICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD.
Contact information
Practice address
1 GUSTAVE L LEVY PL, DEPARTMENT OF PATHOLOGY, NEW YORK, NY 10029-6500
(857) 205-5960
Mailing address
1 GUSTAVE L LEVY PL, DEPARTMENT OF PATHOLOGY, NEW YORK, NY 10029-6500
(857) 205-5960
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
242314
MA
207ZP0101X
Anatomic Pathology Physician
Primary
264869
NY
207ZP0101X
Anatomic Pathology Physician
N5648
TX
Other
Enumeration date
06/15/2007
Last updated
08/05/2012
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