Provider Demographics
NPI:1497229371
Name:AJWANI, ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:AJWANI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:KOTINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 STATE SEAL RD APT 204
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5578
Mailing Address - Country:US
Mailing Address - Phone:973-652-2250
Mailing Address - Fax:
Practice Address - Street 1:7 STATE SEAL RD APT 204
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5578
Practice Address - Country:US
Practice Address - Phone:973-652-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY755465163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse