Healthcare Provider Details

I. General information

NPI: 1194926998
Provider Name (Legal Business Name): PAULA D BAPTISTA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CROSS ST
STOUGHTON MA
02072-1634
US

IV. Provider business mailing address

40 CROSS ST
STOUGHTON MA
02072-1634
US

V. Phone/Fax

Practice location:
  • Phone: 781-962-6042
  • Fax:
Mailing address:
  • Phone: 781-962-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number22147
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: