Vasserman, Ilya

Vasserman, Ilya is an individual health care provider with primary practice located at 153 Lewis Str , Lynn MA 01902. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Vasserman, Ilya can be contacted via phone (781) 599-3553.

Contact Information

Primary practice address
153 Lewis Str Lynn MA 01902
Fax: (781) 599-5959
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 20020 Massachusetts

Profile Details

NPI number 1790900892
LBN Legal business name Vasserman, Ilya
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790900892 NPPES
Massachusetts MEDICAID 0201421

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