Provider Demographics
NPI:1376912394
Name:BIRO, ELIZABETH WAGNER
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WAGNER
Last Name:BIRO
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 1:712 LORIMER ST
Mailing Address - Street 2:1L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1330
Mailing Address - Country:US
Mailing Address - Phone:973-216-1502
Mailing Address - Fax:
Practice Address - Street 1:712 LORIMER ST
Practice Address - Street 2:1L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1330
Practice Address - Country:US
Practice Address - Phone:973-216-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker