Dersarkissian, Raffi
Dersarkissian, Raffi is an sole proprietor health care provider with primary practice located at 500 Congress St Suite 2A, Quincy MA 02169-0908. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Dersarkissian, Raffi can be contacted via phone (781) 682-9009.Contact Information
Primary practice address
500 Congress St Suite 2A
Quincy MA 02169-0908
Phone: (781) 682-9009
Fax: (781) 682-0300
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MA150911 | Massachusetts |
Profile Details
| NPI number | 1942234091 |
|---|---|
| LBN Legal business name | Dersarkissian, Raffi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1942234091 | NPPES |
| Massachusetts | MEDICAID | 3152391 |
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