MEDICARE: OLENA DOTSENKO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	27910	NE
2	207R00000X	Internal Medicine Physician	246407	NY

General Provider Information

NPI Number	:	1326228669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLENA DOTSENKO M.D.

Provider Business Mailing Address
First Line	:	1712 10TH AVE APT 2B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-7747
Country	:	US
Telephone Number	:	917-327-0490
Fax Number	:	347-867-8952

Provider Business Practice Location Address
First Line	:	361 91ST ST
Second Line	:	APT. 2
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5807
Country	:	US
Telephone Number	:	917-327-0490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2007
Last Update Date	:	12/15/2025

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