Provider Demographics
NPI:1114057650
Name:NIKOLSKAIA, ELENA B (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:B
Last Name:NIKOLSKAIA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:170 MORTON ST
Mailing Address - Street 2:APT. #702
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3735
Mailing Address - Country:US
Mailing Address - Phone:617-971-3018
Mailing Address - Fax:
Practice Address - Street 1:940 BELMONT STREET
Practice Address - Street 2:BROCKTON VA MEDICAL CENTER
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02401
Practice Address - Country:US
Practice Address - Phone:617-971-3018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-01-25
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Provider Licenses
StateLicense IDTaxonomies
MA2306382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry