Provider Demographics
NPI:1447402847
Name:ELBAZ, RANIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANIA
Middle Name:
Last Name:ELBAZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1200
Mailing Address - Country:US
Mailing Address - Phone:631-254-5437
Mailing Address - Fax:631-940-5943
Practice Address - Street 1:1476 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1200
Practice Address - Country:US
Practice Address - Phone:631-254-5437
Practice Address - Fax:631-940-5943
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054175-11223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry