Healthcare Provider Details

I. General information

NPI: 1952891483
Provider Name (Legal Business Name): ASHLEY PAIGE WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WILSON ST
BEVERLY MA
01915-1131
US

IV. Provider business mailing address

109 OAK ST
NEWTON MA
02464-1492
US

V. Phone/Fax

Practice location:
  • Phone: 978-317-4333
  • Fax:
Mailing address:
  • Phone: 617-658-5611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: