Provider Demographics
NPI:1447209747
Name:HEBERT, PATRICIA A (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:HEBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-0229
Mailing Address - Country:US
Mailing Address - Phone:978-762-3754
Mailing Address - Fax:978-762-3922
Practice Address - Street 1:6 ESSEX CENTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2904
Practice Address - Country:US
Practice Address - Phone:978-979-9552
Practice Address - Fax:978-532-0526
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75834208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00097360OtherMEDICARE RAILROAD