Provider Demographics
NPI:1932906393
Name:ELEWITZ, BEREL (EMTP)
Entity type:Individual
Prefix:
First Name:BEREL
Middle Name:
Last Name:ELEWITZ
Suffix:
Gender:M
Credentials:EMTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5013
Mailing Address - Country:US
Mailing Address - Phone:347-552-4060
Mailing Address - Fax:
Practice Address - Street 1:57 JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5013
Practice Address - Country:US
Practice Address - Phone:347-552-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY480883146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic