| Alexeyenko Medical Associates Pc | |
|
24 State St Lynn MA 01901-1505 | |
| (781) 581-6181 | |
| (781) 599-3229 |
| Full Name | Alexeyenko Medical Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 24 State St, Lynn, Massachusetts |
| Authorized Official Name and Position | Alexandre Alexeyenko (PRESIDENT) |
| Authorized Official Contact | 7815816181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexeyenko Medical Associates Pc 24 State St Lynn MA 01901-1505 Ph: (781) 581-6181 | Alexeyenko Medical Associates Pc 24 State St Lynn MA 01901-1505 Ph: (781) 581-6181 |
| NPI Number | 1669468419 |
|---|---|
| Provider Enumeration Date | 09/26/2005 |
| Last Update Date | 10/14/2014 |
| Medicare PECOS PAC ID | 0042253643 |
|---|---|
| Medicare Enrollment ID | O20050606000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669468419 | NPI | - | NPPES |
| 9785647 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 77955 (Massachusetts) | Primary |
| Provider Name | Alexandre Alexeyenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568464279 PECOS PAC ID: 7214970813 Enrollment ID: I20050614000286 |
| Provider Name | Irina Seliverstov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386646099 PECOS PAC ID: 5092729095 Enrollment ID: I20060130000274 |
| Provider Name | Irina Natapov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619979408 PECOS PAC ID: 1254438492 Enrollment ID: I20070522000582 |
| Provider Name | Sophia Viner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396993317 PECOS PAC ID: 9638239379 Enrollment ID: I20081125000406 |
| Provider Name | Yulia Rapoport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376041905 PECOS PAC ID: 9739420241 Enrollment ID: I20190410002358 |
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