Provider Demographics
NPI:1134513120
Name:SEVERI, ERIC MATTHEW (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MATTHEW
Last Name:SEVERI
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ATWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01611-3332
Mailing Address - Country:US
Mailing Address - Phone:508-344-1936
Mailing Address - Fax:
Practice Address - Street 1:5 PAUL X TIVNAN DR
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-2191
Practice Address - Country:US
Practice Address - Phone:508-854-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215088163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse