Provider Demographics
NPI:1720392376
Name:BRATKOVSKY, ELENA (NP)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:BRATKOVSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 MAYFAIR DR S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6911
Mailing Address - Country:US
Mailing Address - Phone:347-312-4979
Mailing Address - Fax:
Practice Address - Street 1:462 MAYFAIR DR S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6911
Practice Address - Country:US
Practice Address - Phone:347-312-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY505922-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics