Individual
JILLIAN R LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
119 BELMONT ST, WORCESTER, MA 01605-2903
(508) 334-5603
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4014
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110120930A
—
MA
Enumeration date
07/22/2010
Last updated
10/28/2021
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