Basic Information
Provider Information
NPI: 1003298464
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KINASCHUK
FirstName: VERONIKA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NOVGORODOVA
OtherFirstName: VERONIKA
OtherMiddleName:  
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 1 MEDICAL CENTER BLVD
Address2:  
City: CHESTER
State: PA
PostalCode: 190133902
CountryCode: US
TelephoneNumber: (610) 447-7612
FaxNumber: 6104477615
Practice Location
Address1: 1 MEDICAL CENTER BLVD
Address2:  
City: CHESTER
State: PA
PostalCode: 190133902
CountryCode: US
TelephoneNumber: 6104477612
FaxNumber: 6104477615
Other Information
ProviderEnumerationDate: 06/22/2015
LastUpdateDate: 07/05/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMT209818PAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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