Provider Demographics
NPI:1659335339
Name:DRAZNIN, ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:DRAZNIN
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:PO BOX 917
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80151-0917
Mailing Address - Country:US
Mailing Address - Phone:303-788-4106
Mailing Address - Fax:303-788-4259
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:#320
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-788-4106
Practice Address - Fax:303-788-4259
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24425208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01244250Medicaid
CO01244250Medicaid
E04786Medicare UPIN