Provider Demographics
NPI:1780082156
Name:ELMAZI, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ELMAZI
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 1:15 W AYLESBURY RD
Mailing Address - Street 2:601
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4142
Mailing Address - Country:US
Mailing Address - Phone:410-917-7704
Mailing Address - Fax:
Practice Address - Street 1:15 W AYLESBURY RD
Practice Address - Street 2:601
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4142
Practice Address - Country:US
Practice Address - Phone:410-917-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM00722172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker