Provider Demographics
NPI:1275786394
Name:ABDELAZIZ, ELSA (LPN)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:ABDELAZIZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BENEHLEY PLACE
Mailing Address - Street 2:24C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475
Mailing Address - Country:US
Mailing Address - Phone:347-602-7447
Mailing Address - Fax:
Practice Address - Street 1:140 BENCHLEY PL
Practice Address - Street 2:APT #24 C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3502
Practice Address - Country:US
Practice Address - Phone:347-602-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245952164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse