Formal, Elliot S

Formal, Elliot S is an individual health care provider with primary practice located at 2510 30Th Ave , Astoria NY 11102-2418. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Formal, Elliot S can be contacted via phone (718) 932-1000.

Contact Information

Primary practice address
2510 30Th Ave Astoria NY 11102-2418
Phone: (718) 932-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 024373 New York

Profile Details

NPI number 1649834656
LBN Legal business name Formal, Elliot S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2019
Last updated Apr 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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