Individual
MRS. ELLA DEGTYAREVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 25TH AVE, SUITE 1-B, BROOKLYN, NY 11214-5443
(718) 372-8099
(718) 372-1068
Mailing address
8700 25TH AVE, SUITE 1-B, BROOKLYN, NY 11214
(718) 372-8099
(718) 372-1068
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02064395
—
NY
Enumeration date
08/01/2006
Last updated
12/04/2014
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