Healthcare Provider Details

I. General information

NPI: 1548125628
Provider Name (Legal Business Name): ELAINE VICTORIA OSADCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALYONA OSADCHA

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LINCOLN SQ
WORCESTER MA
01608-1135
US

IV. Provider business mailing address

103 HOSMER ST
ACTON MA
01720-5412
US

V. Phone/Fax

Practice location:
  • Phone: 508-373-5607
  • Fax:
Mailing address:
  • Phone: 978-201-5503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: