Asena Derohannesian
Nurse Practitioner, Pediatrics in Bridgeport, CT. Individual provider (NPI-1).
NPI number1043685308
StatusActive
Last updated in NPPESOct 17, 2018
Details
- NPI
- 1043685308
- Entity type
- Individual (NPI-1)
- Name
- Asena Derohannesian
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 11, 2015
- Last updated
- Oct 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 6410 | CT | Yes |
Other names
- Asena Levent (Former Name)
Practice location
425 Thorme StBridgeport, CT 06606-3418
Phone 203-275-4115 · Fax 203-275-0198
Mailing address
46 Albion StBridgeport, CT 06605-2602
Phone 203-330-6000
Other practice locations
968 Fairfield Ave
Bridgeport, CT 06605-1116
Bridgeport, CT 06605-1116
Phone 203-330-6000
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