MEDICARE: HEATHER BECKER PA

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	363A00000X	Physician Assistant	1840	MA

General Provider Information

NPI Number	:	1962403634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER BECKER PA

Provider Business Mailing Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	617-732-5636
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 MILL ST
Second Line	:	SUITE 204
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4784
Country	:	US
Telephone Number	:	781-648-9700
Fax Number	:

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	11/08/2012

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Directions to “ HEATHER BECKER PA” Practice Location

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