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General NPI Number Information
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NPI Number | 1669710547
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE FOR ADULTS, PLLC
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 54 HOPEDALE ST
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City | HOPEDALE
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State | MA
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Zip | 01747-1700
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Country | US
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Telephone | 508-473-8373
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Fax | 508-634-8744
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Provider Business Mailing Address
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Address Line | 54 HOPEDALE ST
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City | HOPEDALE
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State | MA
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Zip | 01747-1700
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Country | US
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Telephone | 508-473-8373
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Fax | 508-634-8744
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ELIZABETH A D'ALESIO
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Credential | MSN, ANP
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Telephone | 508-473-8373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 131960
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License Number State | MA
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