Provider Demographics
NPI:1396062303
Name:PAULINO, ELEANOR R (LMT)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:R
Last Name:PAULINO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GROVE ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2259
Mailing Address - Country:US
Mailing Address - Phone:978-239-5543
Mailing Address - Fax:
Practice Address - Street 1:50 GROVE ST STE 204
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2259
Practice Address - Country:US
Practice Address - Phone:978-239-5543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
MA6763225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula