Provider Demographics
NPI:1487213187
Name:PAVLENCHEVA, GALINA (DO)
Entity Type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:PAVLENCHEVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:PENACOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03303-1412
Mailing Address - Country:US
Mailing Address - Phone:603-753-4302
Mailing Address - Fax:603-227-7570
Practice Address - Street 1:4 CRESCENT ST.
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-1412
Practice Address - Country:US
Practice Address - Phone:603-753-4302
Practice Address - Fax:603-227-7570
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH22823207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program