Provider Demographics
NPI:1255014262
Name:HONORE, JOSE B
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:B
Last Name:HONORE
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 1:48 BELCHER ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3710
Mailing Address - Country:US
Mailing Address - Phone:857-773-9966
Mailing Address - Fax:
Practice Address - Street 1:332 TALBOT AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5057
Practice Address - Country:US
Practice Address - Phone:617-708-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator