Provider Demographics
NPI:1003080946
Name:AGRANOVSKY, ELENA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:
Last Name:AGRANOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1857 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3108
Mailing Address - Country:US
Mailing Address - Phone:171-823-2151
Mailing Address - Fax:718-232-1550
Practice Address - Street 1:1857 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3108
Practice Address - Country:US
Practice Address - Phone:718-232-1515
Practice Address - Fax:718-232-1550
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168999207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine