Provider Demographics
NPI:1457390601
Name:KAMENKER-ORLOV, YELENA (MD, PHD)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:KAMENKER-ORLOV
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:YELENA
Other - Middle Name:
Other - Last Name:KAMENKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,PHD
Mailing Address - Street 1:542 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2353
Mailing Address - Country:US
Mailing Address - Phone:617-916-9626
Mailing Address - Fax:
Practice Address - Street 1:WEST ROXBURY VA MEDICAL CENTER, AMBULATORY CARE
Practice Address - Street 2:1400 VFW PARKWAY
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:857-203-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157520207R00000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology