1245482447 NPI number — DR. HOPE MARY WATT-BUCCI PH.D.

Table of content: DR. HOPE MARY WATT-BUCCI PH.D. (NPI 1245482447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245482447 NPI number — DR. HOPE MARY WATT-BUCCI PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WATT-BUCCI
Provider First Name:
HOPE
Provider Middle Name:
MARY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WATT
Provider Other First Name:
HOPE
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245482447
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
152 S HUNTINGTON AVE
Provider Second Line Business Mailing Address:
BUILDING 9, MAIL CODE 11T
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-364-5750
Provider Business Mailing Address Fax Number:
857-364-6316

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
152 S. HUNTINGTON AVE
Provider Second Line Business Practice Location Address:
BUILDING 9 MAIL CODE 11T
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-364-5750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2008

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: 104100000X , with the licence number:  1030514 , 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)





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