Healthcare Provider Details

I. General information

NPI: 1982900874
Provider Name (Legal Business Name): ELINA MOROZOV R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 FRONT ST
CHICOPEE MA
01013-3140
US

IV. Provider business mailing address

9 GRANT ST 2ND FLOOR
WESTFIELD MA
01085-2481
US

V. Phone/Fax

Practice location:
  • Phone: 413-420-2222
  • Fax:
Mailing address:
  • Phone: 413-219-0137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN284030
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN284030
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: