Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 210765 | NY |
N | 111NI0900X | Internist | 210765 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 210765 | NY |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 210765 | NY |
Y | 207RR0500X | Rheumatology | 210765 | NY |
NPI | 1629002548 |
---|---|
Provider Name | Yelena Sokolova |
First Address | Brooklyn, NY 11235-2668 |
Second Address | Brooklyn, NY 11235-2668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02110410 | (05) | NY |
H26763 | (02) |