Provider Demographics
NPI:1659171726
Name:KOVLAGINA-RIOS, YELENA SERGEYEVNA
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:SERGEYEVNA
Last Name:KOVLAGINA-RIOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4554 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1427
Mailing Address - Country:US
Mailing Address - Phone:412-445-2190
Mailing Address - Fax:
Practice Address - Street 1:4554 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-1427
Practice Address - Country:US
Practice Address - Phone:412-445-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP032403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily