Provider Demographics
NPI:1205891132
Name:TEMOCZKO, PAULA (NP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:TEMOCZKO
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 1:281 E HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1278
Mailing Address - Country:US
Mailing Address - Phone:508-278-5573
Mailing Address - Fax:508-278-0347
Practice Address - Street 1:281 E HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-1278
Practice Address - Country:US
Practice Address - Phone:508-278-5573
Practice Address - Fax:508-278-0347
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150866363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1586Medicare ID - Type Unspecified
MAS71957Medicare UPIN