Individual
DR. YELENA MIKICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3550 MAIN ST STE 302, SPRINGFIELD, MA 01107-1088
(413) 781-8290
(413) 737-8540
Mailing address
3550 MAIN ST STE 302, SPRINGFIELD, MA 01107-1088
(413) 781-8290
(413) 732-7628
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
154223
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000006125
BMC HEALTHNET
MA
01
—
0011041
NEIGHBORHOOD HEALTH
MA
01
—
07-40454
UNITED HEALTHCARE
MA
01
—
130833
PILGRIM
MA
01
—
154223
TUFTS
MA
01
—
160036619
RR MEDICARE
MA
01
—
20583
HEALTH NEW ENGLAND
MA
05
—
3170772
—
MA
01
—
875845
US HEALTHCARE
MA
01
—
MIJ18169
BLUE SHIELD OF MASS
MA
Enumeration date
07/19/2005
Last updated
03/07/2019
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