Provider Demographics
NPI:1184864670
Name:VOLNOVA, YELENA
Entity Type:Individual
Prefix:MRS
First Name:YELENA
Middle Name:
Last Name:VOLNOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PROVIDENCE HWY
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1804
Mailing Address - Country:US
Mailing Address - Phone:781-329-5120
Mailing Address - Fax:781-326-0453
Practice Address - Street 1:300 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1804
Practice Address - Country:US
Practice Address - Phone:781-329-5120
Practice Address - Fax:781-326-0453
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6080156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician