Provider Demographics
NPI:1285285288
Name:NEGRETE, THERESA
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:NEGRETE
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 1:18 SINGER BROOK RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4272
Mailing Address - Country:US
Mailing Address - Phone:603-673-0590
Mailing Address - Fax:
Practice Address - Street 1:18 SINGER BROOK RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4272
Practice Address - Country:US
Practice Address - Phone:603-673-0590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider