Provider Demographics
NPI:1821636101
Name:LIMA, JESSYCA TADIOTO (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSYCA
Middle Name:TADIOTO
Last Name:LIMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6355
Mailing Address - Country:US
Mailing Address - Phone:508-872-2002
Mailing Address - Fax:774-777-3151
Practice Address - Street 1:336 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6355
Practice Address - Country:US
Practice Address - Phone:508-872-2002
Practice Address - Fax:774-777-3151
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical