MEDICARE: DR. ELINA NACHEVNIK 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	208000000X	Pediatrics Physician	25MA07431900	NJ

General Provider Information

NPI Number	:	1396778684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELINA NACHEVNIK M.D.

Provider Business Mailing Address
First Line	:	34 NORWOOD TER
Second Line	:
City	:	MILLBURN
State	:	NJ
Zip	:	07041-1911
Country	:	US
Telephone Number	:	973-376-6553
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 NORTHFIELD AVE STE 7
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-1136
Country	:	US
Telephone Number	:	973-243-0002
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/25/2019

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