Provider Demographics
NPI:1003842584
Name:ERIM, ELIF N (MD)
Entity Type:Individual
Prefix:
First Name:ELIF
Middle Name:N
Last Name:ERIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 VIRBURNUM LA
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413
Mailing Address - Country:US
Mailing Address - Phone:315-734-9354
Mailing Address - Fax:
Practice Address - Street 1:2150 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1788
Practice Address - Country:US
Practice Address - Phone:315-798-4955
Practice Address - Fax:315-798-4740
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246748-1207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD1012Medicare ID - Type Unspecified
H55844Medicare UPIN
NYH55844Medicare UPIN
NYDD1012Medicare PIN