Provider Demographics
NPI:1497710404
Name:VOLFSON, ELENA (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:VOLFSON
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:DR
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:DOUBOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,MPH
Mailing Address - Street 1:26110 CHERRY BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1281
Mailing Address - Country:US
Mailing Address - Phone:609-799-8545
Mailing Address - Fax:
Practice Address - Street 1:317 GEORGE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2008
Practice Address - Country:US
Practice Address - Phone:732-235-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ503862084P0800X
NJ25MA079420002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0078841Medicaid
NJ0078841Medicaid
NJI44749Medicare UPIN