Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 261478 | NY |
NPI | 1285920314 |
---|---|
Provider Name | Yelena Kogelman |
First Address | Ridgewood, NJ 07450-1990 |
Second Address | Brooklyn, NY 11204-4749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 11/10/2018 |