Provider Demographics
NPI:1841646221
Name:ELENA ADAMOV, MD, PC
Entity type:Organization
Organization Name:ELENA ADAMOV, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-834-0616
Mailing Address - Street 1:2 PARK LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6004
Mailing Address - Country:US
Mailing Address - Phone:215-552-0077
Mailing Address - Fax:215-953-9943
Practice Address - Street 1:2 PARK LN
Practice Address - Street 2:SUITE 101
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6004
Practice Address - Country:US
Practice Address - Phone:215-552-0077
Practice Address - Fax:215-953-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430639261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care