Healthcare Provider Details

I. General information

NPI: 1811779010
Provider Name (Legal Business Name): PAMELA ESPINO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 RIVERVIEW RD
BRIGHTON MA
02135-1835
US

IV. Provider business mailing address

79 RIVERVIEW RD
BRIGHTON MA
02135-1835
US

V. Phone/Fax

Practice location:
  • Phone: 857-636-9401
  • Fax:
Mailing address:
  • Phone: 857-636-9401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2382142
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: