Provider Demographics
NPI:1336668011
Name:CHENTSOVA, SVETLANA (NP)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:CHENTSOVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 CHIEF JUSTICE CUSHING HWY STE 2C
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2124
Mailing Address - Country:US
Mailing Address - Phone:781-239-4434
Mailing Address - Fax:781-239-4489
Practice Address - Street 1:760 CHIEF JUSTICE CUSHING HWY STE 2C
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2124
Practice Address - Country:US
Practice Address - Phone:781-239-4434
Practice Address - Fax:781-239-4489
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258522363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner