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General NPI Number Information
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NPI Number | 1902436827
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Entity Type | Organization
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Legal Business Name | VLADIMIR ZEV ZELENKO MD PC.
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 1540 ROUTE 202 STE 7
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City | POMONA
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State | NY
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Zip | 10970-2922
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Country | US
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Telephone | 845-782-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 745 STATE ROUTE 17M STE 770
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City | MONROE
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State | NY
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Zip | 10950-2660
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Country | US
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Telephone | 845-782-0000
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Fax |
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Authorized Official
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Title or Position | MD
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Name | VLADIMIR ZELENKO
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Credential | MD
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Telephone | 845-782-0000
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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 |
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License Number State |
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