Provider Demographics
NPI:1609211127
Name:TAPO, PAUL ZALDY ELIZALDE
Entity Type:Individual
Prefix:
First Name:PAUL ZALDY
Middle Name:ELIZALDE
Last Name:TAPO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 NATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3310
Mailing Address - Country:US
Mailing Address - Phone:516-754-3651
Mailing Address - Fax:
Practice Address - Street 1:214 NATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3310
Practice Address - Country:US
Practice Address - Phone:516-754-3651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309821164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse