Provider Demographics
NPI:1902878317
Name:RATCLIFFE, ELYANNE
Entity Type:Individual
Prefix:DR
First Name:ELYANNE
Middle Name:
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 CABRINI BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3400
Mailing Address - Country:US
Mailing Address - Phone:917-521-9297
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS
Practice Address - Street 2:3959 BROADWAY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-304-7297
Practice Address - Fax:212-544-1974
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0022022080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02622017Medicaid
NY02622017Medicaid
NYI29285Medicare UPIN