Healthcare Provider Details

I. General information

NPI: 1366182289
Provider Name (Legal Business Name): ALEKSANDRA VASHCHENKO GRABB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEKSANDRA VASHCHENKO SMITH MD

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CYPRESS ST STE 8
MANCHESTER NH
03103-3600
US

IV. Provider business mailing address

445 CYPRESS ST STE 8
MANCHESTER NH
03103-3600
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-8647
  • Fax: 603-663-8605
Mailing address:
  • Phone: 603-663-8647
  • Fax: 603-663-8605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number13717
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number97906
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number38709
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: