Basic Information
| Provider Information | |||||||||
| NPI: | 1780662767 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAGE | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 NEPONSET ST FL STREET12 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952655 | ||||||||
| FaxNumber: | 5084255220 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 NEPONSET ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952655 | ||||||||
| FaxNumber: | 5084255220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2006 | ||||||||
| LastUpdateDate: | 09/26/2018 | ||||||||
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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 | 363A00000X | 531 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 042472266 | 01 | THREE RIVERS | OTHER | 67655 | 01 | FALLON COMMUNITY HEALTH P | OTHER | 8301602 | 01 | EVERCARE | OTHER | 042472266 | 01 | TRICARE CHAMPUS | OTHER | 53142 | 01 | HEALTHY START | OTHER | AP1259 | 01 | MEDICARE B | OTHER | CD2665 | 01 | RAILROAD MEDICARE | OTHER | 53142 | 01 | CHILDRENS MEDICAL SECURIT | OTHER |