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Contact Information

OLENA BOLOTOVA, MD
260 PATCHOGUE YAPHANK RD
EAST PATCHOGUE, NY11772-4886
 Phone: 631-654-8755
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for OLENA BOLOTOVA · (Female)

NPI Number 1417300732
Status Active
Credentials MD
Entity Individual
Enumeration date 07/21/2016
Last updated 08/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 311738
  • NY Other A400268620 MEDICARE
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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