Basic Information
Provider Information
NPI: 1134182918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ACENAS-RECIENTES
FirstName: ELIZABETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ACENAS
OtherFirstName: ELIZABETH
OtherMiddleName: SISON
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 233 NOSTRAND AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 11205
CountryCode: US
TelephoneNumber: 7188265911
FaxNumber: 7188265860
Practice Location
Address1: 546 EASTERN PARKWAY
Address2: EMPIRE CENTER
City: BROOKLYN
State: NY
PostalCode: 11225
CountryCode: US
TelephoneNumber: 7186044800
FaxNumber: 7186044828
Other Information
ProviderEnumerationDate: 04/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X1635101NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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