Individual
ELINA SHALOMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9810 64TH AVE APT 3H, REGO PARK, NY 11374-2502
(917) 517-9743
(917) 517-9743
Mailing address
9810 64TH AVE APT 3H, REGO PARK, NY 11374-2502
(347) 306-5031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011421
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
09/25/2006
Last updated
04/18/2011
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