person
Derick Yensila Ngoran
Psychiatric/Mental Health Nurse Practitioner in Boston, Massachusetts
NPI 1932719135

Derick Yensila Ngoran is a Psychiatric/Mental Health Nurse Practitioner based in Terre Haute, MA and is specialized in Psychiatric/Mental Health. Derick Yensila Ngoran practices in Boston, MA. The NPI Number for Derick Yensila Ngoran is 1932719135 and holds a License No. 71010501A (Massachusetts).

The current practice location address for Derick Yensila Ngoran is 75 Fenwood Rd, Boston, MA and can be reached out via phone at 617-626-9654 and via fax at 617-626-9531.

Location: 75 Fenwood Rd, Boston, MA, 47804-2771
person
Provider Profile Details
NPI Number
1932719135
Provider Name
Derick Yensila Ngoran
Credential
Provider Entity Type
Individual
Gender
Male
Address
75 Fenwood Rd, Boston, MA, 47804-2771
Phone Number
617-626-9654
Fax Number
617-626-9531
Provider Enumeration Date
08/04/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
75 Fenwood Rd
City
State
Zip
02115-6103
Phone Number
617-626-9654
Fax Number
617-626-9531
person
Provider Business Mailing Address Details
Address
75 Fenwood Rd
City
State
Zip
02115-6103
Phone Number
617-626-9654
Fax Number
617-626-9531
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
71010501A (Indiana)
Definition
Definition to come...
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