Provider Demographics
NPI:1679194021
Name:GREGORIAN, FELIX SAMSON
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:SAMSON
Last Name:GREGORIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BLUEBERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1235
Mailing Address - Country:US
Mailing Address - Phone:978-828-3817
Mailing Address - Fax:
Practice Address - Street 1:3 BLUEBERRY HILL LN
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1235
Practice Address - Country:US
Practice Address - Phone:978-828-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35212278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care