Basic Information
Provider Information
NPI: 1801279682
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARKINSON
FirstName: ELIZABETH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 506 6TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112153609
CountryCode: US
TelephoneNumber: 7187805260
FaxNumber: 7187803266
Practice Location
Address1: 506 6TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112153609
CountryCode: US
TelephoneNumber: 7187805260
FaxNumber: 7187803266
Other Information
ProviderEnumerationDate: 06/30/2015
LastUpdateDate: 03/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X294530-01NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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