MEDICARE: ELLEN ZLOBINSKIY

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	363LP2300X	Primary Care Nurse Practitioner	F335668-1	NY

General Provider Information

NPI Number	:	1235451287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN ZLOBINSKIY

Provider Business Mailing Address
First Line	:	400 FORT WASHINGTON AVE
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10033-6849
Country	:	US
Telephone Number	:	212-795-9500
Fax Number	:	212-795-9500

Provider Business Practice Location Address
First Line	:	400 FORT WASHINGTON AVE
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10033-6849
Country	:	US
Telephone Number	:	212-795-9500
Fax Number	:	212-795-9501

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

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	02/18/2010

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