Healthcare Provider Details

I. General information

NPI: 1124563408
Provider Name (Legal Business Name): LENA NAJJARIAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 BROADWAY
MASSAPEQUA NY
11758-5031
US

IV. Provider business mailing address

627 BROADWAY
MASSAPEQUA NY
11758-5031
US

V. Phone/Fax

Practice location:
  • Phone: 347-857-9651
  • Fax: 844-940-3927
Mailing address:
  • Phone: 347-857-9651
  • Fax: 844-940-3927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number020447
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberTPPA557
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number25MP00677600
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number020447
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: