MEDICARE: YELENA SHILIMOVA 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	204311	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
2	204311	OTHER	NY	LICENSE NUMBER

General Provider Information

NPI Number	:	1730144809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA SHILIMOVA M.D.

Provider Business Mailing Address
First Line	:	1009 BRIGHTON BEACH AVE
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5659
Country	:	US
Telephone Number	:	718-975-8500
Fax Number	:	718-975-8502

Provider Business Practice Location Address
First Line	:	1009 BRIGHTON BEACH AVE
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5659
Country	:	US
Telephone Number	:	718-975-8500
Fax Number	:	718-975-8502

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	05/18/2023

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