Provider Demographics
NPI:1306022173
Name:ELMALEM, VALERIE ILANA (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:ILANA
Last Name:ELMALEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 E 14TH ST STE 319S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4284
Mailing Address - Country:US
Mailing Address - Phone:212-614-8206
Mailing Address - Fax:212-979-4512
Practice Address - Street 1:310 E 14TH ST STE 319S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4284
Practice Address - Country:US
Practice Address - Phone:212-614-8206
Practice Address - Fax:212-979-4512
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54706-020207W00000X
GA061732207W00000X
NY264799207WX0109X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology