Provider Demographics
NPI:1942503503
Name:AZOULAY, ELLIOT (RN)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:AZOULAY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HORTON DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2858
Mailing Address - Country:US
Mailing Address - Phone:845-664-4535
Mailing Address - Fax:
Practice Address - Street 1:101 HORTON DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2858
Practice Address - Country:US
Practice Address - Phone:845-664-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY613327-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse