Provider Demographics
NPI:1760128318
Name:HIZON, ELICE MARIE CAPITULO (MD)
Entity Type:Individual
Prefix:MS
First Name:ELICE MARIE
Middle Name:CAPITULO
Last Name:HIZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LENOX AVENUE, HARLEM HOSPITAL CENTER-
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:506 LENOX AVENUE, HARLEM HOSPITAL CENTER-
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037
Practice Address - Country:US
Practice Address - Phone:212-939-4020
Practice Address - Fax:212-939-4022
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program