Provider Demographics
NPI:1285417048
Name:VEGA, MARITZA
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:VEGA
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 1:127 HOW ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-5615
Mailing Address - Country:US
Mailing Address - Phone:978-241-3400
Mailing Address - Fax:978-241-3515
Practice Address - Street 1:127 HOW ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5615
Practice Address - Country:US
Practice Address - Phone:978-241-3400
Practice Address - Fax:978-241-3515
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator