Individual provider · Type 1 NPI

Asena Derohannesian

Pediatric Nurse Practitioner · Bridgeport, CT

NPI number 1043685308 Active

Practice location

425 Thorme St
Bridgeport, CT 06606-3418

Call (203) 275-4115 Map

Fax (203) 275-0198

Mailing address

46 Albion St
Bridgeport, CT 06605-2602

Other practice locations

  • 968 Fairfield Ave, Bridgeport, CT 06605-1116 · (203) 330-6000

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X6410 (CT)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1043685308

Asena Derohannesian's National Provider Identifier is 1043685308, issued on Dec 11, 2015. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Bridgeport, CT. The record was last updated on Oct 17, 2018.