Provider Demographics
NPI:1497711428
Name:REIS, MARIA CONSTANCE (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CONSTANCE
Last Name:REIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:851 MIDDLE ST
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1778
Mailing Address - Country:US
Mailing Address - Phone:508-235-5400
Mailing Address - Fax:508-235-5477
Practice Address - Street 1:851 MIDDLE ST
Practice Address - Street 2:SUITE 3400
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1778
Practice Address - Country:US
Practice Address - Phone:508-235-5400
Practice Address - Fax:508-235-5477
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA161539363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA220020Medicare PIN
S52453Medicare UPIN
MAA2903801Medicare PIN
NP0998Medicare PIN
MAA3132301Medicare PIN