Healthcare Provider Details

I. General information

NPI: 1285318642
Provider Name (Legal Business Name): LIZAVETA ABOISHAVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGHLAND AVE
SALEM MA
01970
US

IV. Provider business mailing address

SALEM HOSPITAL 81 HIGHLAND AVE PRACTICE
SALEM MA
01970
US

V. Phone/Fax

Practice location:
  • Phone: 978-354-4009
  • Fax:
Mailing address:
  • Phone: 978-354-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1027022
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: