MEDICARE: DR. ELLA ZAVOLUNOVA MD

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	237321	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659469260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLA ZAVOLUNOVA MD

Provider Business Mailing Address
First Line	:	3347 91ST ST
Second Line	:	SUITE 1J
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1749
Country	:	US
Telephone Number	:	718-424-2332
Fax Number	:	718-424-2386

Provider Business Practice Location Address
First Line	:	3347 91ST ST
Second Line	:	SUITE 1J
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1749
Country	:	US
Telephone Number	:	718-424-2332
Fax Number	:	718-424-2386

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/02/2012

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