Provider Demographics
NPI:1740142793
Name:MEHIGAN, JEFFREY (LMT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MEHIGAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MAYBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-6202
Mailing Address - Country:US
Mailing Address - Phone:617-905-6930
Mailing Address - Fax:
Practice Address - Street 1:14 MCGRATH HWY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4505
Practice Address - Country:US
Practice Address - Phone:617-996-6591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-28
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15511225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist