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Organization
OLENA KSOVRELI PHYSICIAN PC
Active
Organization
OLENA KSOVRELI PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLENA KSOVRELI MD (PRESIDENT)
(718) 745-1236
Entity
Organization
Contact information
Practice address
6735 RIDGE BLVD, BROOKLYN, NY 11220-5248
(718) 745-1236
Mailing address
145 95TH ST, BROOKLYN, NY 11209-7252
(718) 833-5924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
221578
NY
Other
Enumeration date
02/27/2009
Last updated
02/27/2009
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