Basic Information
| Provider Information | |||||||||
| NPI: | 1538273297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUGBEE | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | HIBBARD | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 NEPONSET ST FL ST2 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088569510 | ||||||||
| FaxNumber: | 5088531907 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 GOLD STAR BLVD. | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088569510 | ||||||||
| FaxNumber: | 5088531907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 11/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 2490 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 042477266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 042472266 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 0701335 | 01 | WELFARE MEDICAID | OTHER | 2779432 | 01 | CIGNA HEALTH PLAN | OTHER | 787398 | 01 | MVP HEALTH CARE | OTHER | AA4053 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | 7551642 | 01 | AETNA US HEALTHCARE | OTHER | 42392 | 01 | FALLON COMMUNITY HEALTH | OTHER | OT0068 | 01 | BLUE CROSS | OTHER | 0701335 | 05 | MA | MEDICAID |