Provider Demographics
NPI:1417197476
Name:BRYAN M. ELZHOLZ M.D., P.C.
Entity Type:Organization
Organization Name:BRYAN M. ELZHOLZ M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:ELZHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-806-7371
Mailing Address - Street 1:400 E 71ST ST APT 19G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4818
Mailing Address - Country:US
Mailing Address - Phone:917-806-7371
Mailing Address - Fax:718-222-8958
Practice Address - Street 1:400 E 71 ST
Practice Address - Street 2:APT 19 G
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10021-4818
Practice Address - Country:US
Practice Address - Phone:917-806-7371
Practice Address - Fax:718-222-8958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty