MEDICARE: YELENA KOGELMAN M.D

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	282N00000X	General Acute Care Hospital	261478-1	NY
2	2080P0205X	Pediatric Endocrinology Physician	261478	NY

General Provider Information

NPI Number	:	1285920314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA KOGELMAN M.D

Provider Business Mailing Address
First Line	:	579 FRANKLIN TPKE
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-1990
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4749
Country	:	US
Telephone Number	:	718-283-7500
Fax Number	:	718-748-4203

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

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	10/11/2018

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