Provider Demographics
NPI:1447363395
Name:VATH, PAMELA M (NP APRN BC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:M
Last Name:VATH
Suffix:
Gender:F
Credentials:NP APRN BC
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Mailing Address - Street 1:11 DUANE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864
Mailing Address - Country:US
Mailing Address - Phone:978-276-0080
Mailing Address - Fax:978-276-0090
Practice Address - Street 1:21 MAIN ST
Practice Address - Street 2:STE 2C RHEUMATOLOGY & INTERNAL MEDICINE ASSOCIATES PC
Practice Address - City:N READING
Practice Address - State:MA
Practice Address - Zip Code:01864
Practice Address - Country:US
Practice Address - Phone:978-664-1606
Practice Address - Fax:978-664-5316
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN116482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0341631Medicaid
NP1054OtherBC
MA0341631Medicaid
NP3069Medicare ID - Type Unspecified