Provider Demographics
NPI:1184924474
Name:HEALTHY PLANET MEDICAL PLLC
Entity type:Organization
Organization Name:HEALTHY PLANET MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FROLOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-295-5229
Mailing Address - Street 1:186 LEFFERTS RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1346
Mailing Address - Country:US
Mailing Address - Phone:516-295-5229
Mailing Address - Fax:516-295-3820
Practice Address - Street 1:2651 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3915
Practice Address - Country:US
Practice Address - Phone:718-769-4100
Practice Address - Fax:718-769-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232381207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty