1316228992 NPI number — MRS. MELISSA ANN SARIS N.P.

Table of content: MRS. MELISSA ANN SARIS N.P. (NPI 1316228992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316228992 NPI number — MRS. MELISSA ANN SARIS N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARIS
Provider First Name:
MELISSA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUNTER
Provider Other First Name:
MELISSA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316228992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
978 BOYLSTON STREET
Provider Second Line Business Mailing Address:
CVS MINUTE CLINIC
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-244-0821
Provider Business Mailing Address Fax Number:
617-244-1935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
978 BOYLSTON STREET
Provider Second Line Business Practice Location Address:
CVS MINUTE CLINIC
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-244-0821
Provider Business Practice Location Address Fax Number:
617-244-1935
Provider Enumeration Date:
09/08/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN2264040 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)