Provider Demographics
NPI:1477638179
Name:STYBEL, ELENA BORISOVNA (DO)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:BORISOVNA
Last Name:STYBEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:ELENA
Other - Middle Name:BORISOVNA
Other - Last Name:STYBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD/DO
Mailing Address - Street 1:100 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2927
Mailing Address - Country:US
Mailing Address - Phone:631-264-1800
Mailing Address - Fax:631-264-1813
Practice Address - Street 1:100 W OAK ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2927
Practice Address - Country:US
Practice Address - Phone:631-264-1800
Practice Address - Fax:631-264-1813
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5996897OtherGHI
NY02581428Medicaid
NYES00263P10OtherBLUE CROSS BLUE SHIELD
NY1780360OtherCIGNA
NYP3072088OtherOXFORD
NY7497491OtherUNITED HEALTH CARE
NY7497491OtherAETNA PPO
NY159265OtherVYTRA
NYES00263P10OtherBLUE CROSS BLUE SHIELD
NY1780360OtherCIGNA