Provider Demographics
NPI:1871538777
Name:USERO, PAULINITA ARROYO (OTR L)
Entity type:Individual
Prefix:MS
First Name:PAULINITA
Middle Name:ARROYO
Last Name:USERO
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MS
Other - First Name:NITA
Other - Middle Name:ARROYO
Other - Last Name:USERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR L
Mailing Address - Street 1:1410 MARBLEHEAD CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2086
Mailing Address - Country:US
Mailing Address - Phone:910-392-8021
Mailing Address - Fax:910-392-8033
Practice Address - Street 1:1705 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7111
Practice Address - Country:US
Practice Address - Phone:910-392-8021
Practice Address - Fax:910-392-8033
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCOT LICENSE # 0962174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7384584Medicaid
NC0162LOtherBCBS
NC7210493Medicaid
NC7210493Medicaid