Provider Demographics
NPI:1992699185
Name:IZZARD, ELANN MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:ELANN
Middle Name:MARIE
Last Name:IZZARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ALDEN CT
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3405
Mailing Address - Country:US
Mailing Address - Phone:828-230-1426
Mailing Address - Fax:
Practice Address - Street 1:100 WHITE PINE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4497
Practice Address - Country:US
Practice Address - Phone:518-640-9512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist