Provider Demographics
NPI:1952307621
Name:ELKIN, CHARLES M (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:ELKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:244 WESTCHESTER AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2900
Mailing Address - Country:US
Mailing Address - Phone:800-501-6388
Mailing Address - Fax:914-872-2470
Practice Address - Street 1:DAVIS AVE AT E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4615
Practice Address - Country:US
Practice Address - Phone:914-681-1260
Practice Address - Fax:914-681-2906
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1488202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A98142Medicare UPIN
NY05D001Medicare ID - Type Unspecified