Provider Demographics
NPI:1538140579
Name:VEDENSKY, VERONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:VEDENSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:DUBROV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-9147
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:781-871-2940
Practice Address - Street 1:75 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-9147
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:781-871-2940
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042297845OtherHCVM
MA69818OtherHVD PILGRIM HEALTH CARE
MA209212OtherTUFTS
MA0023384OtherNEIGHBORHOOD HLTH PLAN
MA0124036Medicaid
MA042297845OtherTRICARE
MAB1044501OtherCIGNA
MAJ22629OtherBCBS
MA042297845OtherUNITED HEALTH CARE
MA042297845OtherGREAT WEST HEALTH CARE
MA62140OtherFALLON
MA7889137OtherAETNA
MA042297845OtherPRIVATE HEALTHCARE SYSTEM
MA042297845OtherDOC FIRST
MA042297845OtherGIC UNICARE
MA042297845OtherUNITED HEALTH CARE
MA7889137OtherAETNA