Provider Demographics
NPI:1720160724
Name:MACHIELE, ELIZABETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:MACHIELE
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 LINDEN OAKS
Mailing Address - Street 2:SUITE 200 PANORAMA PEDIATRIC GROUP RLLP
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625
Mailing Address - Country:US
Mailing Address - Phone:585-381-4830
Mailing Address - Fax:585-381-1821
Practice Address - Street 1:220 LINDEN OAKS
Practice Address - Street 2:SUITE 200 PANORAMA PEDIATRIC GROUP RLLP
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625
Practice Address - Country:US
Practice Address - Phone:585-381-4830
Practice Address - Fax:585-381-1821
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY197054208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02166567Medicaid
NY7833232OtherAETNA
NY107027DLOtherPREFERRED CARE
NY107027DLOtherPREFERRED CARE
NYI46731Medicare UPIN