Basic Information
| Provider Information | |||||||||
| NPI: | 1952534935 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELITE MEDICAL SERVICES,PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 234658 | ||||||||
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| City: | GREAT NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110234658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312771803 | ||||||||
| FaxNumber: | 6315810015 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 E 63RD ST | ||||||||
| Address2: | LOBBY D | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100657660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123083088 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2009 | ||||||||
| LastUpdateDate: | 05/31/2011 | ||||||||
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| AuthorizedOfficialLastName: | TERRANNI | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6312771803 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.