Provider Demographics
NPI:1437360914
Name:ALESHINA, SVETLANA V (OD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:V
Last Name:ALESHINA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 W ANTHEM WAY
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0467
Mailing Address - Country:US
Mailing Address - Phone:623-551-6334
Mailing Address - Fax:623-551-6338
Practice Address - Street 1:4435 W ANTHEM WAY
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-0467
Practice Address - Country:US
Practice Address - Phone:623-551-6334
Practice Address - Fax:623-551-6338
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1481152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist