1154176535 NPI number — HEATHER MICHELE GOTTIER ED.M & C.A.S

Table of content: HEATHER MICHELE GOTTIER ED.M & C.A.S (NPI 1154176535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154176535 NPI number — HEATHER MICHELE GOTTIER ED.M & C.A.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOTTIER
Provider First Name:
HEATHER
Provider Middle Name:
MICHELE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ED.M & C.A.S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PORRIELLO
Provider Other First Name:
HEATHER
Provider Other Middle Name:
MICHELE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154176535
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 MASSACHUSETTS AVE FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02139-3345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-500-2067
Provider Business Mailing Address Fax Number:
617-649-8520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 MASSACHUSETTS AVE FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02139-3345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-500-2067
Provider Business Practice Location Address Fax Number:
617-649-8520
Provider Enumeration Date:
04/19/2024

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)





Copyright © 2007-2024 www.npivalidator.com