Provider Demographics
NPI:1174843171
Name:ELLIOTT, EMILY CORDELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CORDELIA
Last Name:ELLIOTT
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 1:18 E 48TH ST
Mailing Address - Street 2:SUITE 1301-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1014
Mailing Address - Country:US
Mailing Address - Phone:646-847-9814
Mailing Address - Fax:
Practice Address - Street 1:18 E 48TH ST
Practice Address - Street 2:SUITE 1301-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1014
Practice Address - Country:US
Practice Address - Phone:646-847-9814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2631972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program