Provider Demographics
NPI:1851725048
Name:PEREIRA, EDUARDO CESAR (NP)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:CESAR
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SUMMER ST APT B3
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2631
Mailing Address - Country:US
Mailing Address - Phone:617-504-5518
Mailing Address - Fax:
Practice Address - Street 1:13 FIELDSTONE LN
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-5560
Practice Address - Country:US
Practice Address - Phone:508-647-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2013-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2265003363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health