Provider Demographics
NPI:1104464494
Name:NATANOVA, ELONA (RPH)
Entity type:Individual
Prefix:MS
First Name:ELONA
Middle Name:
Last Name:NATANOVA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5456A MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3453
Mailing Address - Country:US
Mailing Address - Phone:718-366-6900
Mailing Address - Fax:718-366-6901
Practice Address - Street 1:5456A MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3453
Practice Address - Country:US
Practice Address - Phone:718-366-6900
Practice Address - Fax:718-366-6901
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066179208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology