Provider Demographics
NPI:1790992691
Name:ACEVEDO, ALIZABETH J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIZABETH
Middle Name:J
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3536 CAMBRIDGE AVE
Mailing Address - Street 2:APT 6B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1768
Mailing Address - Country:US
Mailing Address - Phone:917-562-0296
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY251282-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program