Provider Demographics
NPI:1992827067
Name:BARTZOKIS, ELENIE C (MD)
Entity Type:Individual
Prefix:
First Name:ELENIE
Middle Name:C
Last Name:BARTZOKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELENIE
Other - Middle Name:B
Other - Last Name:CHADBOURNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:243 GREAT PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4104
Mailing Address - Country:US
Mailing Address - Phone:781-398-2300
Mailing Address - Fax:
Practice Address - Street 1:1000 WINTER ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1436
Practice Address - Country:US
Practice Address - Phone:781-398-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2015-02-20
Deactivation Date:2013-04-25
Deactivation Code:
Reactivation Date:2015-02-17
Provider Licenses
StateLicense IDTaxonomies
MA59924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine