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General NPI Number Information
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NPI Number | 1215058367
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Entity Type | Individual
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Provider Name | ROSEMARY E POMPONIO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 376 ARSENAL ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2892
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Country | US
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Telephone | 617-953-5817
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Fax | 617-795-7082
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Provider Business Mailing Address
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Address Line | 136 NICHOLS AVE
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City | WATERTOWN
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State | MA
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Zip | 02472-4134
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Country | US
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Telephone | 617-744-1178
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 55752
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License Number State | MA
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