Provider Demographics
NPI:1720094576
Name:KORENFELD, YELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:KORENFELD
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 1:559 WITTICH TER
Mailing Address - Street 2:
Mailing Address - City:RIVERVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6006
Mailing Address - Country:US
Mailing Address - Phone:201-505-9457
Mailing Address - Fax:201-943-2646
Practice Address - Street 1:596 ANDERSON AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1831
Practice Address - Country:US
Practice Address - Phone:201-943-2700
Practice Address - Fax:201-943-2646
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ64701207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7101902Medicaid
NJ528305Medicare ID - Type Unspecified
NJ7101902Medicaid