Basic Information
| Provider Information | |||||||||
| NPI: | 1861416943 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WALDO | ||||||||
| FirstName: | ELAINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7111 FAIRWAY DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334184207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003306565 | ||||||||
| FaxNumber: | 5617127349 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 E 32ND ST FL 10 | ||||||||
| Address2: | PATHOLOGY DEPARTMENT | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128896225 | ||||||||
| FaxNumber: | 2128898269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 09/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 035044 | CT | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 103978-1 | NY | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.