Provider Demographics
NPI:1316015720
Name:ENRIQUEZ, EVELYN PACIS (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:PACIS
Last Name:ENRIQUEZ
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 1:222 E 80TH ST
Mailing Address - Street 2:APT.2-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0558
Mailing Address - Country:US
Mailing Address - Phone:212-744-1639
Mailing Address - Fax:212-744-1639
Practice Address - Street 1:27TH STREET AND FIRST AVE BELLEVUE
Practice Address - Street 2:HOSPITAL CENTER
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-3019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123422207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine