1902562176 NPI number — DULCE ESTRELLA PALACIOS NP

Table of content: DULCE ESTRELLA PALACIOS NP (NPI 1902562176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902562176 NPI number — DULCE ESTRELLA PALACIOS NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALACIOS
Provider First Name:
DULCE
Provider Middle Name:
ESTRELLA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALACIOS HERNANDEZ
Provider Other First Name:
DULCE
Provider Other Middle Name:
ESTRELLA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1902562176
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
171 MAIN ST STE 203B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01721-1187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-881-3029
Provider Business Mailing Address Fax Number:
508-881-1752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 WORCESTER RD STE 303
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRAMINGHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01702-5316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-665-4317
Provider Business Practice Location Address Fax Number:
508-820-0781
Provider Enumeration Date:
11/11/2021

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: 163W00000X , with the licence number:  2307338 , 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)