Organization · NPI-2

Elite Integrative Group PLLC

Family Medicine, Adult Medicine · Glendale, AZ

NPI number1003771833
StatusActive
Last updated in NPPESDec 23, 2025

Details

NPI
1003771833
Entity type
Organization (NPI-2)
Legal business name
Elite Integrative Group PLLC
Organization subpart
No
Enumeration date
Dec 23, 2025
Certification date
Dec 23, 2025
Last updated
Dec 23, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QA0505X Family Medicine, Adult Medicine––Yes
202D00000X Integrative Medicine––

Practice location

5422 W Thunderbird Rd # 202
Glendale, AZ 85306-4700

Phone 646-752-4685

Mailing address

5422 W Thunderbird Rd # 202
Glendale, AZ 85306-4700

Phone 646-752-4685

Authorized official

Ela Suyunova
Owner
6467524685

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