Provider Demographics
NPI:1396445441
Name:BELLIVEAU, PAULINE GISELE (CPT)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:GISELE
Last Name:BELLIVEAU
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 NATHANIEL DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5075
Mailing Address - Country:US
Mailing Address - Phone:603-494-0854
Mailing Address - Fax:
Practice Address - Street 1:71 LOWELL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4866
Practice Address - Country:US
Practice Address - Phone:603-882-6335
Practice Address - Fax:603-882-6340
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHCPHT-123979183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician