Healthcare Provider Details

I. General information

NPI: 1083525612
Provider Name (Legal Business Name): JENNIFER HERRMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BURLINGTON MALL ROAD
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

2004 HILL TOP RD
SCOTCH PLAINS NJ
07076-4661
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-5100
  • Fax:
Mailing address:
  • Phone: 516-448-2860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number802737
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN10019325
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: