Healthcare Provider Details

I. General information

NPI: 1649156951
Provider Name (Legal Business Name): IRMA FEJZIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ALFRED ST STE 370
WOBURN MA
01801-1929
US

IV. Provider business mailing address

180 GREEN ST
MELROSE MA
02176-1900
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2382716
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: