Provider Demographics
NPI:1861859449
Name:ABARCA, JENNY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:ABARCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SABLE RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1015
Mailing Address - Country:US
Mailing Address - Phone:617-320-7808
Mailing Address - Fax:
Practice Address - Street 1:9 SABLE RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1015
Practice Address - Country:US
Practice Address - Phone:617-320-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker