Provider Demographics
NPI:1225337660
Name:KENEZ, ELIZABETH LEANNE (MD)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:LEANNE
Last Name:KENEZ
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 1:110 IRVING ST NW
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE, SUITE NA 1177
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-8080
Mailing Address - Fax:202-877-7633
Practice Address - Street 1:110 IRVING STREET NW
Practice Address - Street 2:SUITE NA 1177
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-8080
Practice Address - Fax:202-877-7633
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077263207P00000X
DCMD042115207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine