Doctor Name: | SELENA MARIE MACHIA |
NPI Number: | 1063751923 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA4624 |
Business Practice Address: | 480 Hawthorn St North Dartmouth, MA - 027473729 |
Business Phone Number: | 5089739100 |
Business Fax Number: | 5089739155 |
Mailing Address: | 200 Mill Rd, Suite 180 FAIRHAVEN |
State: | MA |
Postal Code: | 027195252 |
Phone Number: | 5089732000 |
Fax Number: | 5089732002 |
NPI Enumeration Date: | 02/12/2013 |
NPI Last Update Date: | 02/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA4624 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |