Provider Demographics
NPI:1902479777
Name:PIROZHKOV, ELENA S (DC)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:S
Last Name:PIROZHKOV
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WARREN ST APT 1809
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3719
Mailing Address - Country:US
Mailing Address - Phone:719-623-9509
Mailing Address - Fax:
Practice Address - Street 1:60 CHRISTOPHER COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2945
Practice Address - Country:US
Practice Address - Phone:201-389-8043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00784100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor