Organization
LOUIS G. JENIS, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS G JENIS M.D. (PRESIDENT)
(617) 754-6363
Entity
Organization
Contact information
Practice address
125 PARKER HILL AVE, CONVERSE 4, ROXBURY CROSSING, MA 02120-2847
(617) 754-6363
(617) 754-5593
Mailing address
125 PARKER HILL AVE, CONVERSE 4, ROXBURY CROSSING, MA 02120-2847
(617) 754-6363
(617) 754-5593
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
76427
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076427
TUFTS
MA
01
—
33391
FALLON
MA
05
—
9714731
—
MA
Enumeration date
09/30/2005
Last updated
08/22/2020
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