Provider Demographics
NPI:1083874226
Name:ELAM, RASHIAH (MD)
Entity Type:Individual
Prefix:
First Name:RASHIAH
Middle Name:
Last Name:ELAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:294 PIERMONT AVENUE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1641
Mailing Address - Country:US
Mailing Address - Phone:917-736-7577
Mailing Address - Fax:
Practice Address - Street 1:294 PIERMONT AVENUE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1641
Practice Address - Country:US
Practice Address - Phone:917-736-7577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY248946-1207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine