1477577799 NPI number — ERIK N. WATSON M.D.

Table of content: MS. KENIA RODRIGUEZ PSYD (NPI 1740598762)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477577799 NPI number — ERIK N. WATSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WATSON
Provider First Name:
ERIK
Provider Middle Name:
N.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1477577799
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
159 PLEASANT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATTLEBORO
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02703-2442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-226-0213
Provider Business Mailing Address Fax Number:
508-226-6820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
159 PLEASANT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATTLEBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02703-2442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-226-0213
Provider Business Practice Location Address Fax Number:
508-226-6820
Provider Enumeration Date:
07/27/2006

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: 207R00000X , with the licence number:  152719 , 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: 3165043 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000028114 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 359 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 004263 . This is a "RIBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0400738 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: B10233201 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J15756 . This is a "MABC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 66266 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 719217 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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