Provider Demographics
NPI:1265100077
Name:BASHAGUROVA, ANZHELIKA
Entity type:Individual
Prefix:
First Name:ANZHELIKA
Middle Name:
Last Name:BASHAGUROVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 DANIEL WEBSTER HWY
Mailing Address - Street 2:APP. #2309
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054
Mailing Address - Country:US
Mailing Address - Phone:603-233-9559
Mailing Address - Fax:
Practice Address - Street 1:246 DANIEL WEBSTER HWY
Practice Address - Street 2:APP. #2309
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054
Practice Address - Country:US
Practice Address - Phone:603-233-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-06
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care