Basic Information
Provider Information
NPI: 1699754515
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEGATT
FirstName: ELIZABETH
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 210 WESTCHESTER AVE
Address2: 3RD FLOOR
City: WHITE PLAINS
State: NY
PostalCode: 106042901
CountryCode: US
TelephoneNumber: 9146813146
FaxNumber: 9146826403
Practice Location
Address1: 1 THEALL RD
Address2:  
City: RYE
State: NY
PostalCode: 105801404
CountryCode: US
TelephoneNumber: 9148488800
FaxNumber: 9146826403
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 10/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X136957-1NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X026970CTN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
0063563005NY MEDICAID
751E81/761E7101NYBLUE CROSS DELUXEOTHER
13388416801NYHORIZON HEALTHCARE OF NYOTHER
423007801NYAETNA NON HMOOTHER
612427901NYCIGNAOTHER
13388416801NYBEECH STREETOTHER
13388416801NYPOMCOOTHER
13388416801NYPHCSOTHER
00056001NYCONNECTICAREOTHER
10094401NYUNITED HEALTH CAREOTHER
13388416801NYMULTIPLANOTHER
13388416801NYEMPIRE STATE PLAN (NYS)OTHER
029687901NYGHI PPOOTHER
374593501NYAETNA HMOOTHER
3C759301NYHEALTH NETOTHER
PWP29001NYOXFORDOTHER


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