Provider Demographics
NPI:1376216291
Name:GENIS, ELIZABET ALEKS
Entity Type:Individual
Prefix:
First Name:ELIZABET
Middle Name:ALEKS
Last Name:GENIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 OCEAN AVE APT 5M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4612
Mailing Address - Country:US
Mailing Address - Phone:917-821-9211
Mailing Address - Fax:
Practice Address - Street 1:2675 OCEAN AVE APT 5M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4612
Practice Address - Country:US
Practice Address - Phone:917-821-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program