Individual
DR. ELENA A, IVANINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
178 E 85TH ST FL 4, NEW YORK, NY 10028-2119
(212) 434-3427
Mailing address
178 E 85TH ST FL 4, NEW YORK, NY 10028-2119
(203) 904-4769
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
266023-1
NY
207RG0100X
Gastroenterology Physician
Primary
266023
NY
207RG0100X
Gastroenterology Physician
70574
CT
Other
Enumeration date
05/05/2010
Last updated
06/07/2022
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