Provider Demographics
NPI:1477542116
Name:IVASHINA, ELENA L (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:L
Last Name:IVASHINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:280 MAIN ST
Mailing Address - Street 2:SUITE 210 A
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2919
Mailing Address - Country:US
Mailing Address - Phone:603-577-5300
Mailing Address - Fax:603-577-5305
Practice Address - Street 1:100 HITCHCOCK WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-695-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-16
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH153472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology