Most Relevant Information
Provider Data
NPI Number: | 1003559519 |
Provider Name: | PAULINE PARK |
Entity Type: | Individual |
Taxonomy Code: | 172V00000X |
Specialty: | Community Health Worker |
License Number: |
Most Important Dates
Enumeration Date: | 04/14/2022 |
Last Updated: | 04/14/2022 |
Provider Practice Location
117 SUMMER ST
SOMERVILLE
MA
021432706
Practice Location Phone/Fax
Phone: | 6173542275 |
Fax: |
Provider Mailing Location
117 SUMMER ST
SOMERVILLE
MA
021432706
Provider Mailing Phone/Fax
Phone: | |
Fax: |