EUGENIA BLANK (NPI# 1922143296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922143296 |
| Entity Type | Individual |
| Full Name | EUGENIA BLANK |
| Other Name | EUGENIA SHIKHANOVICH |
| Credential | M.D. |
| Practice Address |
170 Governors Ave Ste 258 Medford MA 02155-1643 |
| Practice Telephone | 7812135201 |
| Practice Fax Number | 7812135255 |
| Mailing Telephone | 7812135201 |
| Mailing Fax Number | 7812135255 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2018-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
230567 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
170 GOVERNORS AVE STE 258 |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-1643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689960197 | David E Miller | Psychiatry & Neurology | 170 Governors Ave Ste 258, Medford, MA 02155 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659519767 | Cynthia Shearn Tainsh | Psychiatry & Neurology | 97 Westwood Rd, Medford, MA 02155-1637 | 2009-01-27 |
| 1528217460 | Christopher Dardis | Psychiatry & Neurology | 2900 State St Ste 101, Medford, OR 97504-8458 | 2008-09-16 |
| 1225249675 | Bruce Ehrenberg | Psychiatry & Neurology | 4 Colby St, Medford, MA 02155-6013 | 2007-05-25 |
| 1366658627 | Nishant Singh Ranawat | Psychiatry & Neurology | Asante Rogue Regional Medical Center, 2825 E Barnett Road, Medford, OR 97504 | 2007-05-15 |
| 1912963661 | Larry Jou Maukonen | Psychiatry & Neurology | 897 Royal Ave, Suite B, Medford, OR 97504 | 2006-04-21 |
| 1265416317 | South Jersey Neurocare Pa | Psychiatry & Neurology | 520 Stokes Rd, Suite A-4, Medford, NJ 08055-2904 | 2005-12-02 |
| 1063412427 | Oscar Adolfo Sanchez | Psychiatry & Neurology | 520 Medical Center Drive, Medford, OR 97504 | 2005-07-28 |
| 1720424591 | Minji Kim | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504-6169 | 2013-05-20 |
| 1578821013 | Sabre Amira Patton-fee | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504 | 2012-05-02 |
| 1689955536 | Pawani Sachar | Psychiatry & Neurology | 920 Royal Ave, Medford, OR 97504-6169 | 2011-09-06 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.