Provider Demographics
NPI:1821773938
Name:DEINEKA, STANISLAV
Entity Type:Individual
Prefix:
First Name:STANISLAV
Middle Name:
Last Name:DEINEKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT STREET, CONCORD HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT STREET, CONCORD HOSPITAL
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-227-7000
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program