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General NPI Number Information
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NPI Number | 1568663599
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Entity Type | Organization
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Legal Business Name | STAROSTA MEDICAL PC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2114 GRAVESEND NECK ROAD
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-769-9100
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Fax | 718-769-7814
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Provider Business Mailing Address
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Address Line | 2114 GRAVESEND NECK ROAD
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-769-9100
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Fax | 718-769-7814
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ELENA STAROSTA
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Credential | MD
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Telephone | 718-769-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 223868
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 212836
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 179462
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 236385
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N0057471
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 207165
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License Number State | NY
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