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ETHELWOLDO ELIAZO MD
NPI 1588794820
Radiology - Diagnostic Radiology in Jamaica, NY

Active since March 06, 2007
15211 89TH AVE, JAMAICA, NY 11432(718) 558-2275 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethelwoldo Eliazo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHELWOLDO ELIAZO MD (NPI 1588794820) is an individual diagnostic radiology provider in Jamaica, New York, licensed in New York (130797) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1588794820
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameETHELWOLDO ELIAZOCredential: MD
Location Address15211 89TH AVEJamaica, NY 11432-3730
Mailing Address15211 89th AveJamaica, NY 11432-3730
Phone(718) 558-2275
Sole ProprietorYes
Enumeration DateMarch 6, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1588794820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in NY · 130797
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
15211 89TH AVE, Jamaica, NY 11432
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Other Identifiers 3

Medicare UPINE38162
Medicare ID-Type UnspecifiedPENDING
Medicaid01010746NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CATHOLIC MEDICAL CENTER OF BROOKLYN AND QUEENS
General Acute Care Hospital
15211 89TH AVE
JAMAICA, NY 11432
Queens County (718) 558-2000
DR. REVANORD PIERRE-LOUIS M.D.
Emergency Medicine
15211 89TH AVE
JAMAICA, NY 11432
Queens County (212) 563-2497
DR. ZUMAIRA FATIMA M.D.,
Internal Medicine (Geriatric Medicine)
15211 89TH AVE
JAMAICA, NY 11432
Queens County (718) 558-2000
ALFREDO WONG MD
Emergency Medicine
15211 89TH AVE, RM.#5100
JAMAICA, NY 11432
Queens County (212) 533-1701
DR. MALAYA SRIVASTAVA M.D.
Emergency Medicine
15211 89TH AVE
JAMAICA, NY 11432
Queens County (212) 563-2497
ALI SEID MIRHOSSEINI MD
Medical Genetics, Ph.D. Medical Genetics
15211 89TH AVE
JAMAICA, NY 11432
Queens County (718) 558-2463
DR. KIRAN DAVE M.D.
Emergency Medicine
15211 89TH AVE
JAMAICA, NY 11432
Queens County (718) 558-2115
CARITAS EMERGENCY MEDICAL SERVICES, PC
Emergency Medicine (Pediatric Emergency Medicine)
15211 89TH AVE, EMERGENCY ROOM
JAMAICA, NY 11432
Queens County (212) 563-2497

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethelwoldo Eliazo's NPI number?

The NPI number for Ethelwoldo Eliazo is 1588794820. It was assigned to this individual provider in the NPPES registry on March 6, 2007.

Where is Ethelwoldo Eliazo located?

Ethelwoldo Eliazo practices at 15211 89th Ave, Jamaica, NY 11432. The listed phone number is (718) 558-2275.

What is Ethelwoldo Eliazo's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Ethelwoldo Eliazo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.