Provider Demographics
NPI:1821019365
Name:PINTO, ROXANNE EMILY (NP)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:EMILY
Last Name:PINTO
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 1:2 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-2394
Mailing Address - Country:US
Mailing Address - Phone:508-758-3948
Mailing Address - Fax:
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:ST LUKE'S EMERGENCY ASSOCIATES, PC
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-961-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211564363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q17926Medicare UPIN