1588793566 NPI number — CONG. OF PRESENTATION OF MARY,INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588793566 NPI number — CONG. OF PRESENTATION OF MARY,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONG. OF PRESENTATION OF MARY,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SISTERS OF THE PRESENTATION OF MARY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588793566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
209 LAWRENCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
METHUEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01844-3849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-687-1369
Provider Business Mailing Address Fax Number:
978-975-1998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 LAWRENCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METHUEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01844-3849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-687-1369
Provider Business Practice Location Address Fax Number:
978-975-1998
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PLASSE
Authorized Official First Name:
CECILE
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVINCIAL SUPERIOR
Authorized Official Telephone Number:
978-685-0980

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , 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)

  • Identifier: 1902083 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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