Potylitsina, Yelena

Potylitsina, Yelena is an sole proprietor health care provider with primary practice located at 1270 Highway 35 Suite 1, Middletown NJ 07748-2014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Potylitsina, Yelena can be contacted via phone (732) 671-1155.

Contact Information

Primary practice address
1270 Highway 35 Suite 1 Middletown NJ 07748-2014
Fax: (732) 671-9630
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA08017300 New Jersey

Profile Details

NPI number 1568592632
LBN Legal business name Potylitsina, Yelena
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2007
Last updated Feb 14th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568592632 NPPES
New Jersey MEDICAID 0139980

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