Vasserman, Ilya
Vasserman, Ilya is an individual health care provider with primary practice located at 153 Lewis Str , Lynn MA 01902. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Vasserman, Ilya can be contacted via phone (781) 599-3553.Contact Information
Primary practice address
153 Lewis Str
Lynn MA 01902
Phone: (781) 599-3553
Fax: (781) 599-5959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 20020 | Massachusetts |
Profile Details
| NPI number | 1790900892 |
|---|---|
| LBN Legal business name | Vasserman, Ilya |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790900892 | NPPES |
| Massachusetts | MEDICAID | 0201421 |
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