Provider Demographics
NPI:1326077538
Name:YEHUDA D. ELIEZRI, M.D. P.C.
Entity Type:Organization
Organization Name:YEHUDA D. ELIEZRI, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ELIEZRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-354-1169
Mailing Address - Street 1:7A MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3516
Mailing Address - Country:US
Mailing Address - Phone:845-354-1169
Mailing Address - Fax:845-362-5126
Practice Address - Street 1:7A MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3516
Practice Address - Country:US
Practice Address - Phone:845-354-1169
Practice Address - Fax:845-362-5126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty