Provider Demographics
NPI:1568679736
Name:MENDELSOHN-ELZAM, CERRAH LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:CERRAH
Middle Name:LYNN
Last Name:MENDELSOHN-ELZAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:67 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1936
Mailing Address - Country:US
Mailing Address - Phone:917-440-0782
Mailing Address - Fax:
Practice Address - Street 1:7 RIVERSVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3697
Practice Address - Country:US
Practice Address - Phone:203-531-1808
Practice Address - Fax:203-531-8326
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045295207P00000X
CT45295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine