Ksovreli, Olena
Ksovreli, Olena is an individual health care provider with primary practice located at Health Sciences Ctr Stony Brook University, Stony Brook NY 11794-8160. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ksovreli, Olena can be contacted via phone (631) 444-8478.Contact Information
Primary practice address
Health Sciences Ctr Stony Brook University
Stony Brook NY 11794-8160
Phone: (631) 444-8478
Fax: (631) 444-7546
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 221578 | New York |
Profile Details
| NPI number | 1821063041 |
|---|---|
| LBN Legal business name | Ksovreli, Olena |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821063041 | NPPES |
| Connecticut | Other | 047041 | CT LICENCE |
| Connecticut | Other | 221578 | CT LICENCE |
| Connecticut | Other | CSP 0044740 | CT LICENCE |
| Connecticut | MEDICAID | 02177879 | CT LICENCE |
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