MEDICARE: MS. AIMEE PONTES TM

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1225375637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AIMEE PONTES TM

Provider Business Mailing Address
First Line	:	52 MISSILE LOOP
Second Line	:
City	:	SWANSEA
State	:	MA
Zip	:	02777-5003
Country	:	US
Telephone Number	:	508-642-5121
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 MYLES STANDISH BLVD
Second Line	:
City	:	TAUNTON
State	:	MA
Zip	:	02780-7387
Country	:	US
Telephone Number	:	508-642-5121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2013
Last Update Date	:	01/07/2013

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