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NPI Code Detail

MEDICARE: MRS. JENIFER ANNE TERSAKYAN PA-C

MEDICARE: MRS. JENIFER ANNE TERSAKYAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA9102663FL
2363AM0700XMedical Physician AssistantC02514MD

General Provider Information

NPI Number : 1366488363
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENIFER ANNE TERSAKYAN PA-C
Provider Business Mailing Address
First Line : PO BOX 6390
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-0390
Country : US
Telephone Number : 443-332-4260
Fax Number :
Provider Business Practice Location Address
First Line : 2114 GENERALS HWY
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7488
Country : US
Telephone Number : 888-808-6483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 11/16/2018

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