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Contact Information

ODETA HYSENAJ, PA
111 HUNTOON MEMORIAL HWY
INNOVATIVE PHYSICIAN SERVICES LLC
ROCHDALE, MA01542
 Phone: 508-892-6000
 Fax: 508-892-6001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ODETA HYSENAJ · (Female)

NPI # 1306835129
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 10/14/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # AP1941
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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