MEDICARE: YELENA FAYNZILBERT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	5101017608	MI

General Provider Information

NPI Number	:	1063670750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA FAYNZILBERT DO

Provider Business Mailing Address
First Line	:	27351 DEQUINDRE RD
Second Line	:
City	:	MADISON HTS
State	:	MI
Zip	:	48071-3487
Country	:	US
Telephone Number	:	248-967-7795
Fax Number	:	248-967-7794

Provider Business Practice Location Address
First Line	:	27351 DEQUINDRE RD
Second Line	:
City	:	MADISON HTS
State	:	MI
Zip	:	48071-3487
Country	:	US
Telephone Number	:	248-967-7795
Fax Number	:	248-967-7794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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Directions to “ YELENA FAYNZILBERT DO” Practice Location

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