Provider Demographics
NPI:1568894822
Name:PIROVA, YELENA (MA)
Entity Type:Individual
Prefix:MS
First Name:YELENA
Middle Name:
Last Name:PIROVA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144-52 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-9997
Mailing Address - Country:US
Mailing Address - Phone:917-519-9533
Mailing Address - Fax:
Practice Address - Street 1:144-52 77TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-9997
Practice Address - Country:US
Practice Address - Phone:917-519-9533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY757131131174400000X
NY757130131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist