1477661791 NPI number — EMILY J DULUDE M.D.

Table of content: EMILY J DULUDE M.D. (NPI 1477661791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477661791 NPI number — EMILY J DULUDE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DULUDE
Provider First Name:
EMILY
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.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:
1477661791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PARK WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAVERHILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-469-5445
Provider Business Mailing Address Fax Number:
978-469-5485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PARK WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAVERHILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01830-6278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-469-5445
Provider Business Practice Location Address Fax Number:
978-469-5485
Provider Enumeration Date:
08/27/2006

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: 207RN0300X , with the licence number:  220292 , 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: 1477661791 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1477661791 . This is a "ANTHEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 30207814 . This is a "NH MEDICAID" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: J27465 . This is a "BCBS OF MASSACHUSETTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2040221 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1477661791 . This is a "ANTHEM BC" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1477661791 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1477661791 . This is a "BOSTON MEDICAL CENTER HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0046023 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110036446A . This is a "MASSHEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1477661791 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7964640 . This is a "AETNA NON HMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1477661791 . This is a "FALLON COMMUNITY HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 970229-02 . This is a "NETWORK" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA119588 . This is a "HARVARD PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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