Individual
ELENA FRADKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5600
(617) 492-3500
Mailing address
300 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5600
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
285922
MA
390200000X
Student in an Organized Health Care Education/Training Program
4301114431
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/03/2015
Last updated
06/24/2021
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