Provider Demographics
NPI:1265003578
Name:VO, EILEEN (PA-C)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CHURCH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-3247
Mailing Address - Country:US
Mailing Address - Phone:617-872-4636
Mailing Address - Fax:
Practice Address - Street 1:20 CHURCH ST APT 11
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-3247
Practice Address - Country:US
Practice Address - Phone:617-872-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant