Healthcare Provider Details

I. General information

NPI: 1447363395
Provider Name (Legal Business Name): PAMELA M VATH NP APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 MAIN ST STE 2C RHEUMATOLOGY & INTERNAL MEDICINE ASSOCIATES PC
N READING MA
01864
US

IV. Provider business mailing address

11 DUANE DR
NORTH READING MA
01864
US

V. Phone/Fax

Practice location:
  • Phone: 978-664-1606
  • Fax: 978-664-5316
Mailing address:
  • Phone: 978-276-0080
  • Fax: 978-276-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN116482
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: