Basic Information
| Provider Information | |||||||||
| NPI: | 1184044927 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PRISTYAZHNYUK | ||||||||
| FirstName: | YELENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 DINA CT | ||||||||
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| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103061185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6465157630 | ||||||||
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| Practice Location | |||||||||
| Address1: | HHC CANCER INSTITUTE AT HARTFORD HOSPITAL | ||||||||
| Address2: | 85 RETREAT AVE | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061062555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602496291 | ||||||||
| FaxNumber: | 8607280151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2014 | ||||||||
| LastUpdateDate: | 01/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 65171 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.