Provider Demographics
NPI:1396307732
Name:FILIPOV, PAVEL ATANASSOV
Entity type:Individual
Prefix:
First Name:PAVEL
Middle Name:ATANASSOV
Last Name:FILIPOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 PARK PL
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2033
Mailing Address - Country:US
Mailing Address - Phone:607-734-4582
Mailing Address - Fax:607-734-4596
Practice Address - Street 1:668 PARK PL
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2033
Practice Address - Country:US
Practice Address - Phone:607-734-4582
Practice Address - Fax:607-734-4596
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-06
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007352213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty