Boornazian, Ava Rose

Boornazian, Ava Rose is an individual health care provider with primary practice located at 56 Franklin St , Waterbury CT 06706-1221. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Boornazian, Ava Rose can be contacted via phone (203) 709-6000.

Contact Information

Primary practice address
56 Franklin St Waterbury CT 06706-1221
Phone: (203) 709-6000
Fax: (203) 709-8849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 002444 Connecticut

Profile Details

NPI number 1639105166
LBN Legal business name Boornazian, Ava Rose
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Oct 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639105166 NPPES
Connecticut MEDICAID 004213253

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