Provider Demographics
NPI:1427310267
Name:LEIFERT, ELIZABETH MARIE (MS)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:LEIFERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 LARCHMONT ACRES
Mailing Address - Street 2:APT C
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3359
Mailing Address - Country:US
Mailing Address - Phone:914-834-6633
Mailing Address - Fax:
Practice Address - Street 1:20 CEDAR ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5247
Practice Address - Country:US
Practice Address - Phone:914-576-5292
Practice Address - Fax:914-576-3983
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1456837174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist