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Ethan Dejesus
NPI 1952169039 · on the registry since 2024
Practice
- Address
- 113 Richdale Ave Unit 15
Cambridge, MA 02140 - Phone
- (413) 275-9373
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-03-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts