Basic Information
Provider Information | |||||||||
NPI: | 1144296682 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ARONSON | ||||||||
FirstName: | LINDA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 630 PLANTATION STREET | ||||||||
Address2: | WOT 12TH FLOOR ATTN PHYSICIAN SERVICES | ||||||||
City: | WORCESTER | ||||||||
State: | MA | ||||||||
PostalCode: | 01605 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5083685529 | ||||||||
FaxNumber: | 5083685530 | ||||||||
Practice Location | |||||||||
Address1: | 340 THOMPSON ROAD | ||||||||
Address2: |   | ||||||||
City: | WEBSTER | ||||||||
State: | MA | ||||||||
PostalCode: | 01570 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5083683110 | ||||||||
FaxNumber: | 5083683113 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/24/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | X | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 178405 | MA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   |
ID Information
ID | Type | State | Issuer | Description | 0324639 | 05 | MA |   | MEDICAID | AA3668 | 01 |   | HARVARD PILGRIM | OTHER | 381298 | 01 |   | MVP HEALTH CARE | OTHER | NP1109 | 01 |   | BLUE CARE ELECT | OTHER | NP1109 | 01 |   | BLUE SHIELD HMO BLUE | OTHER | 45174 | 01 |   | CHILDRENS MEDICAL | OTHER | NP1109 | 01 |   | BLUE SHIELD INDEMNITY | OTHER | 57178 | 01 |   | FALLON COMMUNITY HEALTH | OTHER | 8301129 | 01 |   | EVERCARE | OTHER |