Provider Demographics
NPI:1063165413
Name:RAPOSO, JANEYSE
Entity type:Individual
Prefix:
First Name:JANEYSE
Middle Name:
Last Name:RAPOSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GLENN RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-2410
Mailing Address - Country:US
Mailing Address - Phone:978-994-1584
Mailing Address - Fax:
Practice Address - Street 1:6 TSIENNETO RD STE 300
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-216-0400
Practice Address - Fax:603-216-3800
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1912363A00000X
363A00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program