Healthcare Provider Details

I. General information

NPI: 1760272785
Provider Name (Legal Business Name): JESSICA MARIE DELREY-MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST STE 768
NEWTON MA
02462-1645
US

IV. Provider business mailing address

131 SEAPORT BLVD APT 2002
BOSTON MA
02210-3054
US

V. Phone/Fax

Practice location:
  • Phone: 617-332-2345
  • Fax:
Mailing address:
  • Phone: 954-494-6879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: