Individual
DR. ELISA M JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(855) 644-7644
(617) 724-4707
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
270594
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
CT
Other
Enumeration date
05/14/2013
Last updated
06/18/2022
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