Healthcare Provider Details

I. General information

NPI: 1497882971
Provider Name (Legal Business Name): EILEEN HEGARTY P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 BARTLETT ST SUITE 305
LOWELL MA
01852-1334
US

IV. Provider business mailing address

60 BALLARD RD
PELHAM NH
03076-2947
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-2200
  • Fax: 978-441-2550
Mailing address:
  • Phone: 978-452-2200
  • Fax: 978-441-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number251543
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: