Provider Demographics
NPI:1992768873
Name:GREGORIAN, AYLEEN (DPM FACPM LLC)
Entity type:Individual
Prefix:DR
First Name:AYLEEN
Middle Name:
Last Name:GREGORIAN
Suffix:
Gender:F
Credentials:DPM FACPM LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 NORTH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1037
Mailing Address - Country:US
Mailing Address - Phone:978-501-7176
Mailing Address - Fax:978-456-7842
Practice Address - Street 1:41 NORTH RD STE 202
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1037
Practice Address - Country:US
Practice Address - Phone:978-501-7176
Practice Address - Fax:978-456-7842
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2165213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA4026OtherHARVARD PILGRIM
MA33917OtherHEALTH NEW ENGLAND
MA5119441OtherCIGNA
MA7673533OtherAETNA
MA0323420Medicaid
MA457517OtherTUFTS
MA000000029923OtherBMC
MA216500OtherCONNECTICARE
MAY71085OtherBCBS MA
MAY71085OtherBCBS MA
MA7673533OtherAETNA
MAU87018Medicare UPIN