Provider Demographics
NPI:1477527174
Name:STOCKHEIM, ELINOR (MD)
Entity Type:Individual
Prefix:
First Name:ELINOR
Middle Name:
Last Name:STOCKHEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 2ND AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2739
Mailing Address - Country:US
Mailing Address - Phone:212-598-6516
Mailing Address - Fax:212-598-6212
Practice Address - Street 1:301 E 17TH ST
Practice Address - Street 2:SUITE 208A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-598-6738
Practice Address - Fax:212-598-6212
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY094594207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00E642Medicare ID - Type Unspecified