Basic Information
| Provider Information | |||||||||
| NPI: | 1962059725 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAULO | ||||||||
| FirstName: | ROSEMONDE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 244 RUMNEY RD # 2890031 | ||||||||
| Address2: | |||||||||
| City: | REVERE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021515614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816327565 | ||||||||
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| Practice Location | |||||||||
| Address1: | 73 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | SAUGUS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019061605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812338123 | ||||||||
| FaxNumber: | 7816582494 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2019 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 234838 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.