Provider Demographics
NPI:1629298658
Name:PARRY, HEATHER (PA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PARRY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CENTENNIAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7935
Mailing Address - Country:US
Mailing Address - Phone:978-531-0800
Mailing Address - Fax:978-531-2929
Practice Address - Street 1:4 CENTENNIAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7935
Practice Address - Country:US
Practice Address - Phone:978-531-0800
Practice Address - Fax:978-531-2929
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1431208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1431OtherSTATE LICENSE