1487021291 NPI number — CHRISTINE ELIZABETH BRIGID FRITSCH BSW, MSW

Table of content: CHRISTINE ELIZABETH BRIGID FRITSCH BSW, MSW (NPI 1487021291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487021291 NPI number — CHRISTINE ELIZABETH BRIGID FRITSCH BSW, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRITSCH
Provider First Name:
CHRISTINE
Provider Middle Name:
ELIZABETH BRIGID
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BSW, MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRITSCH
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSW, MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487021291
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
91 ARMOUR ST
Provider Second Line Business Mailing Address:
LEVEL 2
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02740-2403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
774-502-1782
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 ALDRIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-4827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-830-0000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2015

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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