1639130651 NPI number — DR. PATRICIA A TWEEDIE D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639130651 NPI number — DR. PATRICIA A TWEEDIE D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

TWEEDIE

Provider First Name:

PATRICIA

Provider Middle Name:

A

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

D.O.

Provider Gender Code:

F

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:

1639130651

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/03/2010

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

289 PLEASANT ST

Provider Second Line Business Mailing Address:

SUITE 102

Provider Business Mailing Address City Name:

FALL RIVER

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02721-3005

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

508-674-7779

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

289 PLEASANT ST

Provider Second Line Business Practice Location Address:

SUITE 102

Provider Business Practice Location Address City Name:

FALL RIVER

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

02721-3005

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

508-674-7779

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

03/29/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  227233 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 29247-6 . This is a "RHODE ISLAND BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 3694205 . This is a "AETNA, US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 712059 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: J40132 . This is a "BC/BS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 408537 . This is a "BLUE CHIP OF R.I." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 6601003 . This is a "UNITED HEALTHCARE OF N.E." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 9735721 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 2019540 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 964850-01 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 9842957 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: AA77017 . This is a "PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 1790880490 . This is a "BOSTON MEDICAL CENTER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".