1265424758 NPI number — DR. STEPHANIE A PARIS-WHITNEY O.D.

Table of content: DR. STEPHANIE A PARIS-WHITNEY O.D. (NPI 1265424758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265424758 NPI number — DR. STEPHANIE A PARIS-WHITNEY O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARIS-WHITNEY
Provider First Name:
STEPHANIE
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

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:
1265424758
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 TRAPELO RD
Provider Second Line Business Mailing Address:
SUITE 184
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02451-7333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-890-7797
Provider Business Mailing Address Fax Number:
781-890-2507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 TRAPELO RD
Provider Second Line Business Practice Location Address:
SUITE 184
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02451-7333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-890-7797
Provider Business Practice Location Address Fax Number:
781-890-2507
Provider Enumeration Date:
08/19/2005

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: 152WC0802X , with the licence number:  3675 , 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: 7704123 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA8378 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: W22020 . This is a "BCBS-MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 755280 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42957 . This is a "1199 NATIONAL BENEFIT FUN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3442143 . This is a "AETNA/US HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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