DR. YELENA KOMISSAROVA (NPI# 1538318860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538318860 |
| Entity Type | Individual |
| Full Name | DR. YELENA KOMISSAROVA |
| Credential | MD |
| Practice Address |
241 North Rd Poughkeepsie NY 12601 |
| Mailing Address |
19 Bradhurst Ave Ste 3100n Hawthorne NY 10532-2140 |
| Practice Telephone | 8454835000 |
| Mailing Telephone | 9149099018 |
| Mailing Fax Number | 9149099028 |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2019-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
245065 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS LICENSE | 245065 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 612 Mocksville Ave, Salisbury, NC 281442732 | 7042105061 | 7042105337 |
| Street Address |
241 NORTH RD |
| City | POUGHKEEPSIE |
| State | NY |
| Zip Code | 12601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922006501 | Lobsang Lhungay | Anesthesiology | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2005-07-08 |
| 1457958118 | Brian Lucas Kaczmarek | Registered Nurse | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-10-06 |
| 1750988796 | Joshua John Foote | Registered Nurse | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-10-02 |
| 1467079681 | Kwaku Baidoo | Registered Nurse | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-07-03 |
| 1770106874 | Marissa Lyn Campilii | Physician Assistant | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-05-22 |
| 1205468642 | Scott Peters | Registered Nurse | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-02-04 |
| 1376199463 | William Martinez | Registered Nurse | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2019-08-14 |
| 1710532908 | Annmarie Scalzo | Nurse Practitioner | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2019-08-05 |
| 1568014793 | Lauren Davis | Physician Assistant | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2019-07-09 |
| 1235791138 | Amanda Mae Frankie | Physician Assistant | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2019-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348425 | Hudson Valley Radiologists, PC | Radiology | 57 Kingwood Park, Poughkeepsie, NY 12601 | 2020-05-21 |
| 1063049088 | Jaquellah Taylor | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center 45 Reade Place, Poughkeepsie, NY 12601 | 2020-03-27 |
| 1053957050 | Jasmine Syin-lan Miller | Student in an Organized Health Care Education/Training Program | 3399 North Road, Marist College Msc 12617, Poughkeepsie, NY 12601 | 2019-11-25 |
| 1144864224 | Kim Beverly | Technician | 16 Tamidan Road, Poughkeepsle, NY 12601 | 2019-11-01 |
| 1851852768 | Marwa H Abdalla | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center, 45 Reade Place, Poughkeepsie, NY 12601 | 2019-03-26 |
| 1619459047 | Victoria Bozydaj | Occupational Therapy Assistant | 50 Rinaldi Boulevard Apt 7r, Poughkeepsie, NY 12601 | 2018-09-01 |
| 1821589953 | Avo Gregory Serafino | Physician Assistant | 228 Donnelly, Poughkeepsie, NY 12601 | 2018-05-24 |
| 1649771486 | Raewyn Kalisha Clayton | Registered Nurse | 31 Forbus Street Apt C2, Poughkeepsie, NY 12601 | 2018-02-27 |
| 1780108761 | Ronica Dorothy White | Licensed Practical Nurse | 7c Muldowney Circle, Poughkeepsie, NY 12601 | 2017-08-01 |
| 1336662048 | Ashley Elizabeth Travers | Licensed Practical Nurse | 100 Innis Ave, Poughkeepsie, NY 12601 | 2017-07-25 |
| Find all providers in zip 12601 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327611 | Adel Mostafavi, Md PC | Psychiatry & Neurology | 104 W 40th St Rm 400, New York, NY 10018-3692 | 2020-08-17 |
| 1023632015 | Child and Adult Clinical Psychiatry PC | Psychiatry & Neurology | 75 Prospect St Ste 110, Huntington, NY 11743-3320 | 2020-06-04 |
| 1598306441 | Place of Mind Child, Adolescent, and Adult Psychiatry P.C. | Psychiatry & Neurology | 240 Central Park S Apt 2h, New York, NY 10019-1435 | 2019-10-02 |
| 1881102267 | Park Avenue Physicians PC | Psychiatry & Neurology | 5 W 86th St Apt 1b, New York, NY 10024-3663 | 2018-01-19 |
| 1518478080 | Diego G. Calabria Physician P.C. | Psychiatry & Neurology | 366 N Broadway Ste 304, Jericho, NY 11753-2000 | 2017-10-23 |
| 1013426865 | Bebsy Estefan Md PC | Psychiatry & Neurology | 3050 Corlear Ave # Phb, Bronx, NY 10463-5180 | 2017-09-25 |
| 1902281629 | Derek Rudge | Psychiatry & Neurology | 1051 Riverside Dr Rm 235, New York, NY 10032-1007 | 2015-07-23 |
| 1275918096 | Dr Omar Bashayan Physician Pllc | Psychiatry & Neurology | 155 W 68th St Apt 1102, New York, NY 10023-5816 | 2015-07-22 |
| 1740676766 | Maura E Tappen | Psychiatry & Neurology | 1860 South Ave, Rochester, NY 14620-4229 | 2015-04-07 |
| 1194119560 | Krishen Persaud | Psychiatry & Neurology | Stony Brook Psychiatric Associates, Ufpc, Sbumc, Hsc Level 10, Rm.020, Stony Brook, NY 11794-8101 | 2015-03-24 |
| Find all providers with the same taxonomy | ||||
| City | POUGHKEEPSIE |
| Zip Code | 12601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.