Provider Demographics
NPI:1437414745
Name:SZURA, ELZBIETA EWA
Entity Type:Individual
Prefix:MRS
First Name:ELZBIETA
Middle Name:EWA
Last Name:SZURA
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 1:6080 60TH DR
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3536
Mailing Address - Country:US
Mailing Address - Phone:718-386-0967
Mailing Address - Fax:
Practice Address - Street 1:6080 60TH DR
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3536
Practice Address - Country:US
Practice Address - Phone:718-386-0967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1756789174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist