1821137217 NPI number — MS. JENNA GRACE PARAFINCZUK MSW

Table of content: MS. JENNA GRACE PARAFINCZUK MSW (NPI 1821137217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821137217 NPI number — MS. JENNA GRACE PARAFINCZUK MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARAFINCZUK
Provider First Name:
JENNA
Provider Middle Name:
GRACE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821137217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 MASSACHUSETTS AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-534-2398
Provider Business Mailing Address Fax Number:
617-534-4688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 MEDFORD AVE
Provider Second Line Business Practice Location Address:
CHARLESTOWN HIGH SCHOOL
Provider Business Practice Location Address City Name:
CHARLESTOWN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
339-224-1145
Provider Business Practice Location Address Fax Number:
617-534-9956
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041S0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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