Provider Demographics
NPI:1154635902
Name:DR ELIOT Y GHATAN MD PC
Entity Type:Organization
Organization Name:DR ELIOT Y GHATAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT Y
Authorized Official - Middle Name:
Authorized Official - Last Name:GHATAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-253-2053
Mailing Address - Street 1:1226 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5102
Mailing Address - Country:US
Mailing Address - Phone:718-253-2053
Mailing Address - Fax:718-253-2051
Practice Address - Street 1:1226 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5102
Practice Address - Country:US
Practice Address - Phone:718-253-2053
Practice Address - Fax:718-253-2051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty