1740590868 NPI number — MRS. REGINA CALAZANS WESTON CASE MANAGER

Table of content: MRS. REGINA CALAZANS WESTON CASE MANAGER (NPI 1740590868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740590868 NPI number — MRS. REGINA CALAZANS WESTON CASE MANAGER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTON
Provider First Name:
REGINA
Provider Middle Name:
CALAZANS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CASE MANAGER
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:
1740590868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13 POND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02766-2207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-809-9050
Provider Business Mailing Address Fax Number:
508-809-9050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 CENTRE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROCKTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02302-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-586-6300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2010

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: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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