Doctor Name: | CARISSA C RAND |
NPI Number: | 1124177118 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 1656 |
Business Practice Address: | 541 Main St Suite 414 South Weymouth, MA - 021901868 |
Business Phone Number: | 7819521433 |
Business Fax Number: | 5086302462 |
Mailing Address: | 541 Main St, Suite 414 SOUTH WEYMOUTH |
State: | MA |
Postal Code: | 021901868 |
Phone Number: | 7819521433 |
Fax Number: | 5086302462 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 03/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1656 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |