Provider Demographics
NPI:1922530922
Name:ELBAZ, WINNIE MALKIE
Entity Type:Individual
Prefix:MISS
First Name:WINNIE
Middle Name:MALKIE
Last Name:ELBAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 37TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4380
Mailing Address - Country:US
Mailing Address - Phone:718-215-5311
Mailing Address - Fax:718-865-5196
Practice Address - Street 1:201 BRIGHTON 1ST RD
Practice Address - Street 2:APT 5B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7650
Practice Address - Country:US
Practice Address - Phone:347-359-7011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst