Individual provider Active NPI

Elona Natanova, RPH

  • Clinical Pharmacology Physician
  • Ridgewood, NY
National Provider Identifier
1104464494
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pharmacology PhysicianTaxonomy code 208U00000X
License
066179 Issued in NY
Practice address
5456A Myrtle Ave
Ridgewood, NY 11385-3453
Phone
(718) 366-6900
Fax
(718) 366-6901
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pharmacology Physician 208U00000X 066179 NY Primary

Addresses

Primary practice location

5456A Myrtle Ave
Ridgewood, NY 11385-3453

Mailing address

5456A Myrtle Ave
Ridgewood, NY 11385-3453
Phone (718) 366-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
066179NYMDClinical Pharmacology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1104464494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5456A MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853453",
            "telephone_number": "718-366-6900",
            "fax_number": "718-366-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5456A MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853453",
            "telephone_number": "718-366-6900",
            "fax_number": "718-366-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATANOVA",
        "first_name": "ELONA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "NY",
            "license": "066179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.