Provider Demographics
NPI:1699741793
Name:STONE, YELENA MATLIN (MD)
Entity type:Individual
Prefix:MS
First Name:YELENA
Middle Name:MATLIN
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-8400
Mailing Address - Country:US
Mailing Address - Phone:516-937-5000
Mailing Address - Fax:516-931-2535
Practice Address - Street 1:530 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3415
Practice Address - Country:US
Practice Address - Phone:516-937-5000
Practice Address - Fax:516-931-2535
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2607174Medicaid
NY2607174Medicaid