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NPI Code Detail

MEDICARE: ANGIE M TRZEPACZ PHD

MEDICARE:   ANGIE M TRZEPACZ  PHD
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
1103T00000XPsychologist8291MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18291OTHERMALICENSE

General Provider Information

NPI Number : 1144281379
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE M TRZEPACZ PHD
Provider Business Mailing Address
First Line : 44A W WALNUT ST
Second Line :
City : MILFORD
State : MA
Zip : 01757
Country : US
Telephone Number : 508-478-4577
Fax Number :
Provider Business Practice Location Address
First Line : 95 WEST STREET
Second Line :
City : WALPOLE
State : MA
Zip : 02081
Country : US
Telephone Number : 508-660-1510
Fax Number : 508-660-3122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 07/08/2007

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Directions to “ ANGIE M TRZEPACZ PHD” Practice Location

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