Provider Demographics
NPI:1225451719
Name:MALEVANAYA, ELENA (MS MHC)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:
Last Name:MALEVANAYA
Suffix:
Gender:F
Credentials:MS MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 SHORE FRONT PKWY APT 8F
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-2116
Mailing Address - Country:US
Mailing Address - Phone:347-840-0546
Mailing Address - Fax:
Practice Address - Street 1:8100 SHORE FRONT PKWY APT 8F
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-2116
Practice Address - Country:US
Practice Address - Phone:347-840-0546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor