Provider Demographics
NPI:1902436827
Name:VLADIMIR ZEV ZELENKO MD PC.
Entity Type:Organization
Organization Name:VLADIMIR ZEV ZELENKO MD PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-782-0000
Mailing Address - Street 1:745 STATE ROUTE 17M STE 770
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2660
Mailing Address - Country:US
Mailing Address - Phone:845-782-0000
Mailing Address - Fax:
Practice Address - Street 1:1540 ROUTE 202 STE 7
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2922
Practice Address - Country:US
Practice Address - Phone:845-782-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty