MEDICARE: ELZANA SABOVIC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	311500000X	Alzheimer Center (Dementia Center)
2	315D00000X	Inpatient Hospice
3	385H00000X	Respite Care
4	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1801330840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELZANA SABOVIC

Provider Business Mailing Address
First Line	:	2447 MICKLE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-6203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2447 MICKLE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-6203
Country	:	US
Telephone Number	:	917-324-6558
Fax Number	:

Authorized Official
Title or Position	:	LPN
Name	:	MS. ELZANA SABOVIC
Credential	:
Telephone Number	:	917-324-6558

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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