NPI 1043685308 · live from the CMS NPI Registry
Asena Derohannesian
Nurse Practitioner, Pediatrics in Bridgeport, CT. National Provider Identifier 1043685308, active.
NPI record
| NPI | 1043685308 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 425 Thorme St, Bridgeport, CT 06606 |
| Practice phone | 203-275-4115 |
| Mailing address | 46 Albion St, Bridgeport, CT 06605 |
| Enumerated | December 11, 2015 |
| Last updated | October 17, 2018 |
| Sole proprietor | No |
| Other names | Asena Levent |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 6410 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.