Derkazarian, Jennifer
Derkazarian, Jennifer is an individual health care provider with primary practice located at Lahey Clinic 41 Mall Rd, Burlington MA 01805-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Derkazarian, Jennifer can be contacted via phone (781) 744-8863.Contact Information
Primary practice address
Lahey Clinic 41 Mall Rd
Burlington MA 01805-0001
Phone: (781) 744-8863
Fax: (781) 744-5261
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 233930 | Massachusetts |
Profile Details
| NPI number | 1669536983 |
|---|---|
| LBN Legal business name | Derkazarian, Jennifer |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2006 |
| Last updated | Dec 7th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669536983 | NPPES |
| Massachusetts | MEDICAID | 110018448A |
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