Provider Demographics
NPI:1790840932
Name:KLEZMER, DEBRA (LMT,RN,C,CRRN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:KLEZMER
Suffix:
Gender:F
Credentials:LMT,RN,C,CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 DIAUTO DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4510
Mailing Address - Country:US
Mailing Address - Phone:781-986-6443
Mailing Address - Fax:781-986-4837
Practice Address - Street 1:42 DIAUTO DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-6202
Practice Address - Country:US
Practice Address - Phone:781-986-6443
Practice Address - Fax:781-986-4837
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA145673163WP0000X
MA079225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ04319OtherBCBS OF MA