Healthcare Provider Details

I. General information

NPI: 1760456552
Provider Name (Legal Business Name): ELENA MARIA BURUIANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 EAST 60TH STREET 808
NEW YORK NY
10022-1064
US

IV. Provider business mailing address

328 E 75TH ST
NEW YORK NY
10021-3317
US

V. Phone/Fax

Practice location:
  • Phone: 212-535-6737
  • Fax:
Mailing address:
  • Phone: 212-535-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number212492
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: