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Individual

JASON MACBETH PENDERGAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
439 S UNION ST UNIT 403, LAWRENCE, MA 01843-2837
(866) 610-2273
(617) 426-1311
Mailing address
439 S UNION ST UNIT 403, LAWRENCE, MA 01843-2837
(866) 610-2273
(617) 426-1311

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN2290756
MA

Other

Enumeration date
08/28/2020
Last updated
08/28/2020
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