Individual
TATYANA NAKHABENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2 MEDICAL CENTER DRIVE, SUITE 309, SPRINGFIELD, MA 01107-1270
(413) 794-8020
(413) 794-2165
Mailing address
280 CHESTNUT STREET, 2ND FL, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1189
NH
363AS0400X
Surgical Physician Assistant
Primary
PA9527
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1189
PHYSICIAN ASSISTANT LICENSE
NH
Enumeration date
08/16/2016
Last updated
05/29/2025
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