Provider Demographics
NPI:1457305450
Name:TOOMAJIAN, ELIZABETH PALMER (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PALMER
Last Name:TOOMAJIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2504
Mailing Address - Country:US
Mailing Address - Phone:413-664-5508
Mailing Address - Fax:
Practice Address - Street 1:820 STATE RD
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3027
Practice Address - Country:US
Practice Address - Phone:413-664-4088
Practice Address - Fax:413-663-6405
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0357081Medicaid
P12649Medicare UPIN
NP2622Medicare ID - Type Unspecified