Basic Information
Provider Information
NPI: 1104245943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELIAS
FirstName: HAROLD
MiddleName: KUNAL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 AMSTERDAM AVE
Address2: CLARK BUILDING, 7TH FLOOR
City: NEW YORK
State: NY
PostalCode: 100251716
CountryCode: US
TelephoneNumber: 2125237321
FaxNumber:  
Practice Location
Address1: 1000 10TH AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100191147
CountryCode: US
TelephoneNumber: 2125238663
FaxNumber: 2125238605
Other Information
ProviderEnumerationDate: 04/09/2014
LastUpdateDate: 06/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X293946NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home