Doctor Name: | MISS DARIA MAMON |
NPI Number: | 1740628676 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 490 Lynnfield St Fl 1 1st Floor Lynn, MA - 019041424 |
Business Phone Number: | 7815819200 |
Business Fax Number: | |
Mailing Address: | 55 Highland Ave, Suite 201 SALEM |
State: | MA |
Postal Code: | 019702185 |
Phone Number: | 9788256620 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2013 |
NPI Last Update Date: | 03/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |