Kooyoomjian, Jill T

Kooyoomjian, Jill T is an individual health care provider with primary practice located at 1 Essex Center Drive Lahey Northshore, Peabody MA 01960-4711. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Kooyoomjian, Jill T can be contacted via phone (978) 538-4370.

Contact Information

Primary practice address
1 Essex Center Drive Lahey Northshore Peabody MA 01960-4711
Phone: (978) 538-4370
Fax: (978) 538-4708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 274888 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN274888 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X 274888 Massachusetts

Profile Details

NPI number 1821240177
LBN Legal business name Kooyoomjian, Jill T
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2008
Last updated Jun 10th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821240177 NPPES
Massachusetts MEDICAID 110080842A

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