Provider Demographics
NPI:1013195346
Name:MINEAR, DOROTHY J (MED)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:J
Last Name:MINEAR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 PARIS ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2750
Mailing Address - Country:US
Mailing Address - Phone:781-874-0207
Mailing Address - Fax:
Practice Address - Street 1:149 SYLVAN ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3564
Practice Address - Country:US
Practice Address - Phone:978-774-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist