Provider Demographics
NPI:1528235991
Name:ELGA, SHANA (MD)
Entity type:Individual
Prefix:DR
First Name:SHANA
Middle Name:
Last Name:ELGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHANA
Other - Middle Name:STEIN
Other - Last Name:ELGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:396 WASHINGTON ST # 266
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6209
Mailing Address - Country:US
Mailing Address - Phone:855-438-8331
Mailing Address - Fax:
Practice Address - Street 1:396 WASHINGTON ST # 266
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6209
Practice Address - Country:US
Practice Address - Phone:855-438-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT726392084P0800X
NJ25MA084251002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry