Healthcare Provider Details

I. General information

NPI: 1316347321
Provider Name (Legal Business Name): FLORENCE PANG R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SAINT GEORGE ST
DUXBURY MA
02332-3812
US

IV. Provider business mailing address

80 SAINT GEORGE ST
DUXBURY MA
02332-3812
US

V. Phone/Fax

Practice location:
  • Phone: 781-934-0106
  • Fax:
Mailing address:
  • Phone: 781-934-0106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberRN2294184
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: