Provider Demographics
NPI:1699900951
Name:FOX, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MOORE ST
Mailing Address - Street 2:10-I
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-3654
Mailing Address - Country:US
Mailing Address - Phone:347-432-4555
Mailing Address - Fax:
Practice Address - Street 1:140 MOORE ST
Practice Address - Street 2:10-I
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-3654
Practice Address - Country:US
Practice Address - Phone:347-432-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270154164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse