Provider Demographics
NPI:1376831339
Name:KOSS, ELANA (MD)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:KOSS
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:POB 1012
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1012
Mailing Address - Country:US
Mailing Address - Phone:516-629-2469
Mailing Address - Fax:516-629-2452
Practice Address - Street 1:100 PORT WASHINGTON BLVD.
Practice Address - Street 2:CARDIAC IMAGING
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1347
Practice Address - Country:US
Practice Address - Phone:516-622-4556
Practice Address - Fax:516-622-4551
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY262157207RC0000X
NY60 262157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine