Provider Demographics
NPI:1568775179
Name:AGOPIAN, ELIZ (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ELIZ
Middle Name:
Last Name:AGOPIAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 NORTH BROADWAY, SUITE 417
Mailing Address - Street 2:PHELPS MEMORIAL HOSPITAL CENTER
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591
Mailing Address - Country:US
Mailing Address - Phone:914-366-5330
Mailing Address - Fax:
Practice Address - Street 1:755 N BROADWAY
Practice Address - Street 2:SUITE 417
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1075
Practice Address - Country:US
Practice Address - Phone:914-366-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2640832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology