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: |