Provider Demographics
NPI:1982202073
Name:MACHARIA, STELLA
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:MACHARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PELHAM ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2060
Mailing Address - Country:US
Mailing Address - Phone:978-683-3491
Mailing Address - Fax:978-683-3058
Practice Address - Street 1:147 PELHAM ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2060
Practice Address - Country:US
Practice Address - Phone:978-683-3491
Practice Address - Fax:978-683-3058
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2284629207QA0505X
MARN2284629363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily