Small, Jessica
Small, Jessica is an individual health care provider with primary practice located at 1611 Cambridge St , Cambridge MA 02138-4302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Small, Jessica can be contacted via phone (617) 661-5500.Contact Information
Primary practice address
1611 Cambridge St
Cambridge MA 02138-4302
Phone: (617) 661-5500
Fax: (617) 661-5136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 214185 | Massachusetts |
Profile Details
| NPI number | 1699736587 |
|---|---|
| LBN Legal business name | Small, Jessica |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Mar 7th, 2021 - about 3 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 | 1699736587 | NPPES |
| Massachusetts | MEDICAID | 2115131 | |
| Massachusetts | Other | 214185 | |
| Massachusetts | Other | J25619 |
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