Provider Demographics
NPI:1972549913
Name:GELFAND, INNA (M/D)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:GELFAND
Suffix:
Gender:F
Credentials:M/D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 AVENUE L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5002
Mailing Address - Country:US
Mailing Address - Phone:718-859-3499
Mailing Address - Fax:718-377-2250
Practice Address - Street 1:1911 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5002
Practice Address - Country:US
Practice Address - Phone:718-859-3499
Practice Address - Fax:718-377-2250
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02191500Medicaid
NYH50114Medicare UPIN
NY5Q6741Medicare PIN