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General NPI Number Information
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NPI Number | 1780854232
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Entity Type | Organization
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Legal Business Name | AMITINA NEUROLOGY PC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 16641 POWELLS COVE BLVD APT 3D
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City | WHITESTONE
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State | NY
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Zip | 11357-1537
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Country | US
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Telephone | 718-541-1521
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Fax | 718-631-1866
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Provider Business Mailing Address
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Address Line | 16641 POWELLS COVE BLVD APT 3D
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City | WHITESTONE
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State | NY
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Zip | 11357-1537
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Country | US
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Telephone | 718-541-1521
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Fax | 718-631-1866
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YELENA AMITINA
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Credential | MD
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Telephone | 718-541-1521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 224927-1
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License Number State | NY
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