Provider Demographics
NPI:1033784533
Name:BARROS, NOEMIA
Entity Type:Individual
Prefix:
First Name:NOEMIA
Middle Name:
Last Name:BARROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FAIRMOUNT AVE # 2
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2742
Mailing Address - Country:US
Mailing Address - Phone:508-863-6865
Mailing Address - Fax:
Practice Address - Street 1:42 FAIRMOUNT AVE # 2
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2742
Practice Address - Country:US
Practice Address - Phone:508-863-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA001436179251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health