Provider Demographics
NPI:1508847559
Name:CLEARY, LINDA B (PAC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:B
Last Name:CLEARY
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:99 LONGWATER CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1643
Mailing Address - Country:US
Mailing Address - Phone:781-829-0930
Mailing Address - Fax:781-829-8933
Practice Address - Street 1:99 LONGWATER CIRCLE SUITE 100
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1795
Practice Address - Country:US
Practice Address - Phone:781-829-0930
Practice Address - Fax:781-829-8933
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2015-10-13
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Provider Licenses
StateLicense IDTaxonomies
MAMA587363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042297845OtherDOC FIRST
MA93477OtherFALLON
MA042297845OtherTRICARE
MAAP2545OtherMEDICARE
MA042297845OtherGREAT WEST HEALTH CARE