Provider Demographics
NPI:1760600076
Name:OSTROMETSKAYA, YELENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:OSTROMETSKAYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 REMSEN ST.
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:917-543-2417
Mailing Address - Fax:
Practice Address - Street 1:110 REMSEN ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4361
Practice Address - Country:US
Practice Address - Phone:917-543-2417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048124-11223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics