Provider Demographics
NPI:1902015357
Name:ELIAS, LAYLA (PA)
Entity Type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:104 UNION AVE
Mailing Address - Street 2:SUITE 804
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1843
Mailing Address - Country:US
Mailing Address - Phone:315-703-5049
Mailing Address - Fax:315-703-5079
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:EDUCATON CLINICAL AFFILIATES
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5111
Practice Address - Fax:315-703-5079
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011743-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant