Provider Demographics
NPI:1346996774
Name:BELANGER, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BELANGER
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 1:20 PONDMEADOW DR STE 101
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3222
Mailing Address - Country:US
Mailing Address - Phone:781-942-7000
Mailing Address - Fax:781-942-7200
Practice Address - Street 1:20 PONDMEADOW DR STE 101
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3222
Practice Address - Country:US
Practice Address - Phone:781-942-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2346697363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty