Provider Demographics
NPI:1467560789
Name:KOUMANS, JELTJE A (MD)
Entity Type:Individual
Prefix:
First Name:JELTJE
Middle Name:A
Last Name:KOUMANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7831
Mailing Address - Country:US
Mailing Address - Phone:781-646-8618
Mailing Address - Fax:
Practice Address - Street 1:33 VALLEY RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-7831
Practice Address - Country:US
Practice Address - Phone:781-646-8618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28251207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology