Provider Demographics
NPI:1124563408
Name:NAJJARIAN, LENA (PA-C)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:NAJJARIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2578 BROADWAY STE 536
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5642
Mailing Address - Country:US
Mailing Address - Phone:212-564-0480
Mailing Address - Fax:800-907-2300
Practice Address - Street 1:220 5TH AVE FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-8017
Practice Address - Country:US
Practice Address - Phone:212-564-0480
Practice Address - Fax:833-907-2300
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020447363A00000X, 363AM0700X, 363A00000X
FLTPPA557363AM0700X, 364SP0809X
NJ25MP00677600363AM0700X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult