Provider Demographics
NPI:1851736110
Name:PRICE, EL'LICIA
Entity type:Individual
Prefix:MS
First Name:EL'LICIA
Middle Name:
Last Name:PRICE
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 1:1230 AMSTERDAM AVE
Mailing Address - Street 2:WHITTIER HALL, APT. 315
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6604
Mailing Address - Country:US
Mailing Address - Phone:202-288-3435
Mailing Address - Fax:
Practice Address - Street 1:1230 AMSTERDAM AVE
Practice Address - Street 2:WHITTIER HALL, APT. 315
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6604
Practice Address - Country:US
Practice Address - Phone:202-288-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program