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NPI Code Detail

MEDICARE: ERMINE CHARLES-PIERRE

MEDICARE: ERMINE CHARLES-PIERRE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLN67318MA

General Provider Information

NPI Number : 1124777073
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERMINE CHARLES-PIERRE
Provider Business Mailing Address
First Line : 45 GLENDOWER RD
Second Line :
City : ROSLINDALE
State : MA
Zip : 02131-4552
Country : US
Telephone Number : 617-429-2468
Fax Number :
Provider Business Practice Location Address
First Line : 72 DEERFIELD AVE
Second Line :
City : WESTWOOD
State : MA
Zip : 02090-1613
Country : US
Telephone Number : 781-326-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2022
Last Update Date : 03/19/2022

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Directions to “ ERMINE CHARLES-PIERRE ” Practice Location

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