Provider Demographics
NPI:1376618256
Name:ALENA ASHENBERG M.D. PEDIATRICS, L.L.C.
Entity type:Organization
Organization Name:ALENA ASHENBERG M.D. PEDIATRICS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-957-4300
Mailing Address - Street 1:505 NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1929
Mailing Address - Country:US
Mailing Address - Phone:978-957-4300
Mailing Address - Fax:978-957-3891
Practice Address - Street 1:505 NASHUA RD
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1929
Practice Address - Country:US
Practice Address - Phone:978-957-4300
Practice Address - Fax:978-957-3891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ 14292OtherBCBS INDIVIDUAL NUMBER
MA077683OtherTUFTS PROVIDER NUMBER
MA978732-01OtherNETWORK HEALTH
MA9740261Medicaid
MAE 98499Medicare UPIN