Provider Demographics
NPI:1972011203
Name:DROZDOV, ELENA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:DROZDOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CANYON RUN RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1101
Mailing Address - Country:US
Mailing Address - Phone:347-559-2812
Mailing Address - Fax:
Practice Address - Street 1:2108 81ST ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2572
Practice Address - Country:US
Practice Address - Phone:347-559-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst