Healthcare Provider Details

I. General information

NPI: 1932250321
Provider Name (Legal Business Name): JENNIFER M LEFAVE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 BAY ST SUITE 206
TAUNTON MA
02780-1085
US

IV. Provider business mailing address

2005 BAY ST SUITE 206
TAUNTON MA
02780-1085
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-2266
  • Fax: 508-823-5689
Mailing address:
  • Phone: 508-822-2266
  • Fax: 508-823-5689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2289
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2289
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: