Provider Demographics
NPI:1356778146
Name:EAST COAST MEDICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:EAST COAST MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/NP
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:VIVEIROS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC, NP-C
Authorized Official - Phone:508-837-1493
Mailing Address - Street 1:149 ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-1511
Mailing Address - Country:US
Mailing Address - Phone:508-567-5275
Mailing Address - Fax:508-567-5275
Practice Address - Street 1:149 ASHLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-1511
Practice Address - Country:US
Practice Address - Phone:508-567-5275
Practice Address - Fax:508-567-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230970207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty