Healthcare Provider Details

I. General information

NPI: 1730555012
Provider Name (Legal Business Name): ANASTASIA ZHUK GUC CRNP-WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 WESTCOTT RD
DANIELSON CT
06239
US

IV. Provider business mailing address

30 STONE DR
NORTHBOROUGH MA
01532-1126
US

V. Phone/Fax

Practice location:
  • Phone: 860-774-0533
  • Fax:
Mailing address:
  • Phone: 978-763-5410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2299400
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: