Provider Demographics
NPI:1215071238
Name:MONTEIRO HAGOPIAN, KRISTIN ALISHA
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ALISHA
Last Name:MONTEIRO HAGOPIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:A
Other - Last Name:MONTIERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:152 CHARGE POND ROAD
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571
Mailing Address - Country:US
Mailing Address - Phone:508-291-8431
Mailing Address - Fax:508-999-8616
Practice Address - Street 1:1563 N MAIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program