Provider Demographics
NPI:1245538818
Name:JULMEUS, KETNA (MED)
Entity type:Individual
Prefix:MRS
First Name:KETNA
Middle Name:
Last Name:JULMEUS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4436
Mailing Address - Country:US
Mailing Address - Phone:781-879-2250
Mailing Address - Fax:781-395-0198
Practice Address - Street 1:186 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4436
Practice Address - Country:US
Practice Address - Phone:781-879-2250
Practice Address - Fax:781-395-0198
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator