Individual
ELENA MADELYN PAVLENKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, A-GNP-C
Contact information
Practice address
98 BINNEY ST, BOSTON, MA 02115-5708
(617) 632-7500
(617) 632-7522
Mailing address
98 BINNEY ST, BOSTON, MA 02115-5708
(617) 632-7500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2339996
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2339996
MA
363LG0600X
Gerontology Nurse Practitioner
RN2339996
MA
Other
Enumeration date
08/23/2023
Last updated
12/20/2023
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