Provider Demographics
NPI:1780666735
Name:ELOWITZ, ERIC H (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:ELOWITZ
Suffix:
Gender:M
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:PO BOX 26547
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-6547
Mailing Address - Country:US
Mailing Address - Phone:212-746-2870
Mailing Address - Fax:
Practice Address - Street 1:525 EAST 68TH ST BOX 99
Practice Address - Street 2:WEILL CORNELL MEDICAL COLLEGE/DEPT OF NEUROSURGERY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172703207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
131623978OtherTAX ID #
NY01428468Medicaid
NY45H592Medicare ID - Type Unspecified
NY01428468Medicaid