Provider Demographics
NPI:1417219502
Name:IONIS, YELENA (MS)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:IONIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 NEPTUNE AVE
Mailing Address - Street 2:#4B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4561
Mailing Address - Country:US
Mailing Address - Phone:347-501-3081
Mailing Address - Fax:
Practice Address - Street 1:445 NEPTUNE AVE
Practice Address - Street 2:#4B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4561
Practice Address - Country:US
Practice Address - Phone:347-501-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY842870174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist