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General NPI Number Information
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NPI Number | 1821949298
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Entity Type | Individual
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Provider Name | JENNIFER KEZERIAN PTA
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Gender | Female
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 95 WYMAN RD
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City | KEENE
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State | NH
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Zip | 03431-5047
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Country | US
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Telephone | 954-320-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 7337 MENCHACA RD UNIT 25
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City | AUSTIN
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State | TX
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Zip | 78745-5339
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Country | US
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Telephone | 954-320-4330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1512
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License Number State | NH
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