Provider Demographics
NPI:1043714603
Name:A ELASSAR MEDICAL PRACTICE P.C
Entity Type:Organization
Organization Name:A ELASSAR MEDICAL PRACTICE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-853-7595
Mailing Address - Street 1:693 5TH AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3164
Mailing Address - Country:US
Mailing Address - Phone:800-853-7595
Mailing Address - Fax:800-780-6167
Practice Address - Street 1:693 5TH AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3164
Practice Address - Country:US
Practice Address - Phone:800-853-7595
Practice Address - Fax:800-780-6167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263089-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty