Provider Demographics
NPI:1063688034
Name:KERTESZ, JENNIFER L (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:KERTESZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:39 RUTLAND ST
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1525
Mailing Address - Country:US
Mailing Address - Phone:908-229-1953
Mailing Address - Fax:
Practice Address - Street 1:39 RUTLAND ST
Practice Address - Street 2:APARTMENT 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-1525
Practice Address - Country:US
Practice Address - Phone:908-229-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2252592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology