=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851802169
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALDO PAUL SFERRA CNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2017
-----------------------------------------------------
Last Update Date | 10/14/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 242 SUTTON ST
-----------------------------------------------------
City | NORTH ANDOVER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01845-1631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-655-1987
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 ATKINS ST
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02135-1602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN2287312
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------