Provider Demographics
NPI:1558801571
Name:MAGYAR, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MAGYAR
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 1:342 YORKSHIRE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-9432
Mailing Address - Country:US
Mailing Address - Phone:860-921-6669
Mailing Address - Fax:
Practice Address - Street 1:342 YORKSHIRE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166
Practice Address - Country:US
Practice Address - Phone:860-921-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician