NPI Code Detail JSON Logo

1114707775 NPI number — KREMENA STEPHANOVA DPT

NPI Number: 1114707775
Health Care Provider/Practitioner: KREMENA STEPHANOVA DPT

Information about “1114707775” NPI (KREMENA STEPHANOVA DPT) exists in 1114707775 in HTML format HTML  |  1114707775 in plain Text format TXT  |  1114707775 in PDF (Portable Document Format) PDF  |  1114707775 in an XML format XML  formats.

NPI Number : 1114707775 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114707775",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STEPHANOVA",
    "FirstName": "KREMENA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "248 EVERETT AVE STE 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHELSEA",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02150-1817",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "617-884-2225",
    "MailingAddressFaxNumber": "617-884-2224",
    "FirstLinePracticeLocationAddress": "99 4TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHELSEA",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02150-2336",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "617-889-2500",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/02/2023",
    "LastUpdateDate": "10/31/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "27217",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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