Provider Demographics
NPI:1346710357
Name:FOX, ELIZABETH REGINA (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:REGINA
Last Name:FOX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:REGINA
Other - Last Name:SOKOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:142 W MAIN ST # 187
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12167-1032
Mailing Address - Country:US
Mailing Address - Phone:607-644-4092
Mailing Address - Fax:
Practice Address - Street 1:142 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:NY
Practice Address - Zip Code:12167-1032
Practice Address - Country:US
Practice Address - Phone:607-644-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619114163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse