Doctor Name: | MICHAELA MARIE MAIONE-BALFORD |
NPI Number: | 1073862561 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 282723 |
Business Practice Address: | 298 Washington St Gloucester, MA - 019304832 |
Business Phone Number: | 9782835079 |
Business Fax Number: | 9782821371 |
Mailing Address: | 298 Washington St, GLOUCESTER |
State: | MA |
Postal Code: | 019304832 |
Phone Number: | 9782835079 |
Fax Number: | 9782821371 |
NPI Enumeration Date: | 08/30/2012 |
NPI Last Update Date: | 08/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 282723 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |