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General NPI Number Information
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NPI Number | 1124777073
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Entity Type | Individual
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Provider Name | ERMINE CHARLES-PIERRE
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Gender | Female
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Dates
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Enumeration Date | 03/19/2022
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Last Update Date | 03/19/2022
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Provider Practice Location Address
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Address Line | 72 DEERFIELD AVE
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City | WESTWOOD
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State | MA
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Zip | 02090-1613
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Country | US
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Telephone | 781-326-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 45 GLENDOWER RD
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City | ROSLINDALE
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State | MA
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Zip | 02131-4552
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Country | US
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Telephone | 617-429-2468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LN67318
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License Number State | MA
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