Provider Demographics
NPI:1780662767
Name:PAGE, HELEN S (PA)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:S
Last Name:PAGE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5 NEPONSET ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-595-2655
Mailing Address - Fax:508-425-5220
Practice Address - Street 1:5 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-595-2655
Practice Address - Fax:508-425-5220
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2018-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA531363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherTHREE RIVERS
67655OtherFALLON COMMUNITY HEALTH P
8301602OtherEVERCARE
042472266OtherTRICARE CHAMPUS
53142OtherHEALTHY START
AP1259OtherMEDICARE B
CD2665OtherRAILROAD MEDICARE
53142OtherCHILDRENS MEDICAL SECURIT