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General NPI Number Information
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NPI Number | 1306041314
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Entity Type | Organization
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Legal Business Name | YELENA SOKOLOVA, MD
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 3567 SHORE PKWY 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11235-2668
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Country | US
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Telephone | 718-648-8877
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Fax | 718-648-4647
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Provider Business Mailing Address
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Address Line | 15 DUNSTER RD
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City | GREAT NECK
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State | NY
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Zip | 11021-4639
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Country | US
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Telephone | 718-468-8877
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Fax | 718-648-4647
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Authorized Official
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Title or Position | OWNER
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Name | DR. YELENA SOKOLOVA
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Credential | M.D.
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Telephone | 718-648-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 210765-1
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License Number State | NY
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