1215262894 NPI number — MICHEL ELIAS AKL, MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215262894 NPI number — MICHEL ELIAS AKL, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHEL ELIAS AKL, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215262894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2626 W STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLEAN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14760-1858
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-373-7440
Provider Business Mailing Address Fax Number:
716-737-5725

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 PRATHER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14701-6820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-488-1200
Provider Business Practice Location Address Fax Number:
716-488-1207
Provider Enumeration Date:
10/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
AKL
Authorized Official First Name:
MICHEL
Authorized Official Middle Name:
ELIAS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
716-373-7440

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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