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General NPI Number Information
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NPI Number | 1003653544
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Entity Type | Organization
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Legal Business Name | ALTIVITAS, PC
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Dates
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Enumeration Date | 07/11/2024
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1049 MAIN ST
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City | WEST BARNSTABLE
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State | MA
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Zip | 02668-1152
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Country | US
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Telephone | 508-744-7105
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Fax | 866-711-4542
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Provider Business Mailing Address
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Address Line | 1049 MAIN ST
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City | WEST BARNSTABLE
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State | MA
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Zip | 02668-1152
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Country | US
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Telephone | 508-744-7105
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Fax | 866-711-4542
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LINDSAY LACORTE
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Credential | DO
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Telephone | 508-737-7196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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