OLENA BOLOTOVA M.D. NPI 1417300732

NPI Information

NPI: 1417300732
Provider Name: OLENA BOLOTOVA, M.D.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

Organization: BROOKHAVEN NEPHROLOGY ASSOCIATES, P.C.

PECOS Registration: Yes

Address:
260 PATCHOGUE YAPHANK RD
EAST PATCHOGUE, NY
ZIP 11772
Phone: (631) 654-8755
Get Directions

Olena Bolotova, M.D. is a nephrology internal medicine in East Patchogue, NY with 12 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Olena Bolotova, M.D. NPI is 1417300732. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

260 PATCHOGUE YAPHANK RD
EAST PATCHOGUE, NY
ZIP 11772-886
Phone: (631) 654-8755

The NPI 1417300732 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2016 and was last updated on 8/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	207RN0300X	Internal Medicine	Nephrology	311738	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A400268620	OTHER	NEW YORK	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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