Healthcare Provider Details

I. General information

NPI: 1215516729
Provider Name (Legal Business Name): KATERYNA CHEPENKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 DANIEL WEBSTER HWY
MERRIMACK NH
03054-4112
US

IV. Provider business mailing address

PO BOX 3677
NASHUA NH
03061-3677
US

V. Phone/Fax

Practice location:
  • Phone: 603-429-1611
  • Fax: 603-429-1285
Mailing address:
  • Phone: 603-577-7972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number39409
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: