Healthcare Provider Details

I. General information

NPI: 1629917398
Provider Name (Legal Business Name): CALLIE REPOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3700
US

IV. Provider business mailing address

363 HIGHLAND AVE
FALL RIVER MA
02720-3700
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-3131
  • Fax:
Mailing address:
  • Phone: 508-679-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: