Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 261321 | MA |
N | 363LG0600X | Nurse Practitioner - Gerontology | NPP37445 | RI |
NPI | 1023298296 |
---|---|
Provider Name | Ms. Sarah Elizabeth Mary Paez |
First Address | Quincy, MA 02169-3837 |
Second Address | Quincy, MA 02169-4339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 25/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110084746A | (05) | MA |