Teresa Ribadenyra, PA-C

Individual provider Active NPI Medical Physician Assistant · Lee, MA

NPI 1336197979 · NPPES record last updated Jan 13, 2010

Key facts

NPI
1336197979
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
177485 (MA)
Practice address
710 Stockbridge Rd
Lee, MA 01238-9316
Phone
(413) 243-0122
Fax
(413) 243-2251
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
177485MAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 177485 MA Yes

Addresses

Primary practice location

710 Stockbridge Rd
Lee, MA 01238-9316

Mailing address

1556 Route 203
Chatham, NY 12037-1708

Other providers in Lee, MA

All providers in Lee, MA · Medical Physician Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.