Provider Demographics
NPI:1992183925
Name:TAL, ELANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELANA
Middle Name:
Last Name:TAL
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 1:1001 MAIN STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203
Mailing Address - Country:US
Mailing Address - Phone:716-636-8284
Mailing Address - Fax:888-315-6494
Practice Address - Street 1:1001 MAIN STREET
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-636-8284
Practice Address - Fax:888-315-6494
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019015703207V00000X
NY312587207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology