ARLENE K DERMOVSESIAN


Address: 830 Harrison Ave, Suite 3500, Boston, MA 02118-2309
Phone: 6176388776

ARLENE K DERMOVSESIAN (NPI# 1720050883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720050883
Entity Type Individual
Full Name ARLENE K DERMOVSESIAN
Credential N.P.
Practice Address 830 Harrison Ave
Suite 3500
Boston
MA 02118-2309
Mailing Address 801 Albany St Fl Ground
Boston
MA 02119-2560
Practice Telephone 6176388776
Practice Fax Number 6174148772
Mailing Telephone 6174145405
Mailing Fax Number 6174146031
Enumeration Date 2006-02-03
Last Update Date 2020-02-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
RN201093 MA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MA 110020046A 05

Office Location

Street Address 830 HARRISON AVE
SUITE 3500
City BOSTON
State MA
Zip Code 02118-2309

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NPI Name Taxonomy Address Enumeration
1316937436 Minh Tam Truong Radiology 830 Harrison Ave, Moakley Building Ll100, Boston, MA 02118 2005-10-28
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1760096606 Fabio Petrocca Student in an Organized Health Care Education/Training Program 830 Harrison Ave, Boston, MA 02118-2905 2020-09-08
1801447495 Kailey Vitale Speech-Language Pathologist 830 Harrison Ave, Boston, MA 02118-2905 2019-09-25
1437718228 Kayla Mcdonald Physician Assistant 830 Harrison Ave, Moakley, Suite 3400, Boston, MA 02118 2019-06-06
1154984888 Elizabeth Tiani Nurse Practitioner 830 Harrison Ave, Boston, MA 02118 2019-04-18
1669938981 Lynsie Rae Adams Nurse Practitioner 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 2019-02-11
1548754385 Lisa Jiyoung Kim Nurse Practitioner 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 2018-06-15
1891226650 Navid Alavi Internal Medicine 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 2017-03-23
1952842189 Samuel Rubin Otolaryngology 830 Harrison Ave, 1st Floor, Boston, MA 02118-2905 2017-03-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649870023 Carlos E Salazar Counselor Hcrc 23 Bradston St., Boston, MA 02118 2020-10-27
1780292607 Jinal Gandhi Student in an Organized Health Care Education/Training Program Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 2020-07-16
1669094777 German Eduardo Velez Student in an Organized Health Care Education/Training Program One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 2020-05-12
1255969895 Isabela Medeiros Heringer Pereira Student in an Organized Health Care Education/Training Program 670 Albany Stree, 4th Floor, Boston, MA 02118 2020-03-30
1033746466 Karan Sunil Hingorani Student in an Organized Health Care Education/Training Program Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 2020-03-25
1326672791 Azza Ahmed Dentist 635 Albany St. G-744, Boston, MA 02118 2020-02-25
1538707401 Jane Margolis Social Worker 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 2019-12-11
1871134833 Supontep Teerakanok Dentist Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 2019-10-01
1750939583 Qasim Silman Ajmi Orthopaedic Surgery Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 2019-08-26
1922655539 Jami Ryan Pollard Physician Assistant 840 Harrison Avenue, Menino Building, Boston, MA 02118 2019-08-20
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649877705 Stacey Rose Tosado Nurse Practitioner 108 Myrtle St Apt 3, Boston, MA 02114-4348 2020-10-02
1881230027 Linda Marie Sabo Nurse Practitioner 300 Pier 4 Blvd Unit 4j, Boston, MA 02210-2644 2019-11-22
1417479940 Sarah Jane Georgia Nurse Practitioner 165 Cambridge St Ste 301, Boston, MA 02114-2751 2017-07-17
1932597499 Sheila Brown Nurse Practitioner 218 Humboldt Avenue, Boston, MA 02121 2015-01-06
1871902635 Lindsy Mary Gusiora Nurse Practitioner 1 Brookline Ave Ste 105, Boston, MA 02215-3421 2014-08-06
1710308218 Kristin Fleischmann-rose Nurse Practitioner 330 Brookline Ave Fl 5, Breastcare Center, Boston, MA 02215-5400 2013-12-31
1033546700 Haidang Truong Kelly Nurse Practitioner 147 Milk St Fl 3, Boston, MA 02109 2013-09-26
1659620821 Darlene Electa Sawicki Nurse Practitioner 55 Fruit Street, Bigelow 1256, Massachusetts General Hospital, Boston, MA 02114 2012-09-04
1710258371 Megan Leahy Grady Nurse Practitioner 165 Cambridge St., Charles River Plaza 5th Floor Mgh Senior Health, Boston, MA 02114 2012-01-13
1568739480 Ariel Leora Watriss Nurse Practitioner 1340 Boylston St Fl 8, Boston, MA 02215-4302 2011-11-21
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Competitor

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City BOSTON
Zip Code 02118

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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