Healthcare Provider Details

I. General information

NPI: 1740874957
Provider Name (Legal Business Name): PIONEER FAMILY HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2021
Last Update Date: 02/28/2021
Certification Date: 02/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 N MAIN ST
SHARON MA
02067-1229
US

IV. Provider business mailing address

178 N MAIN ST
SHARON MA
02067-1229
US

V. Phone/Fax

Practice location:
  • Phone: 617-694-8356
  • Fax:
Mailing address:
  • Phone: 617-694-8356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEILA JANE HALPER
Title or Position: RESIDENT AGENT
Credential: FNP-BC
Phone: 617-694-8356