Individual provider Active NPI

Elena Alexanova

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1902377872
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
709544 Issued in NY
Practice address
2617 E 6TH St
Brooklyn, NY 11235-6208
Phone
(646) 703-3374
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 709544 NY Primary

Addresses

Primary practice location

2617 E 6TH St
Brooklyn, NY 11235-6208

Mailing address

2617 E 6TH St
Brooklyn, NY 11235-6208
Phone (646) 703-3374

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

State licenses

LicenseStateTypeSpecialty
709544NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1902377872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 E 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356208",
            "telephone_number": "646-703-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 E 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356208",
            "telephone_number": "646-703-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANOVA",
        "first_name": "ELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "709544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.