Provider Demographics
NPI:1164785390
Name:CHELNITSKY, ELLEN (DO)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:CHELNITSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133A W END AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4808
Mailing Address - Country:US
Mailing Address - Phone:718-891-1300
Mailing Address - Fax:718-891-1301
Practice Address - Street 1:133A W END AVE STE 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4808
Practice Address - Country:US
Practice Address - Phone:718-891-1300
Practice Address - Fax:718-891-1301
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280614207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine