Provider Demographics
NPI:1356947816
Name:PANASENKA, AKSANA
Entity type:Individual
Prefix:
First Name:AKSANA
Middle Name:
Last Name:PANASENKA
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 1:1970 E 18TH ST APT F12
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3425
Mailing Address - Country:US
Mailing Address - Phone:347-536-0309
Mailing Address - Fax:
Practice Address - Street 1:1970 E 18TH ST APT F12
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3425
Practice Address - Country:US
Practice Address - Phone:347-536-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY708353163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse