TATIANA SUVOROV (NPI# 1346599420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346599420 |
| Entity Type | Individual |
| Full Name | TATIANA SUVOROV |
| Other Name | TATIANA SAUNDERS |
| Practice Address |
Cha Revere Family Care Center 454 Broadway Revere MA 02151 |
| Mailing Address |
Cambridge Health Alliance 1493 Cambridge Street Cambridge MA 02139 |
| Practice Telephone | 7814858222 |
| Mailing Telephone | 6176651000 |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 015788 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA6778 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 East 233rd St, Bronx, NY 10466 | 7189209177 | 7189209106 |
| Street Address |
CHA REVERE FAMILY CARE CENTER 454 BROADWAY |
| City | REVERE |
| State | MA |
| Zip Code | 02151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558853580 | Carla Richman | Behavioral Analyst | 29 Arnold Street, Revere, MA 02151 | 2018-06-05 |
| 1558859850 | Citizens Physical Therapy Inc | Clinic/Center | 221 Beach St, Revere, MA 02151 | 2018-04-23 |
| 1396254892 | Holness Home Care | Home Health | 959 Revere Beach Parkway, Revere, MA 02151 | 2017-09-27 |
| 1841709938 | Stefanie Finocchio-durham | Acupuncturist | 107 Pearl Ave, Apt 3, Revere, MA 02151 | 2017-09-21 |
| 1174064265 | Hope Noelle Crowe | Behavioral Analyst | 164 Winthrop Parkway, Revere, MA 02151 | 2017-03-09 |
| 1033660469 | Driss Bahraoui | Interpreter | 21 Thornton St #1, Revere, MA 02151 | 2016-10-20 |
| 1568910081 | Lindsey J. Ellermeyer | Student in an Organized Health Care Education/Training Program | Revere Community Counseling, 265 Beach Street, Revere, MA 02151 | 2016-09-13 |
| 1851743470 | Jacqueline Galvez | Counselor | 252 Proctor Ave # 3, Revere, MA 02151 | 2016-07-07 |
| 1518321090 | Kathleen Elizabeth Pellecchia | Health Educator | 454 Broadway Fl 3, Revere, MA 02151 | 2016-04-11 |
| 1780098814 | David A Gross | Internal Medicine | Mgh Revere, 385 Broadway, Revere, MA 02151 | 2014-06-17 |
| Find all providers in zip 02151 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164822664 | Patricia Le | Physician Assistant | 454 Broadway, Revere, MA 02151-3034 | 2014-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897024 | Eoin Moriarty | Physician Assistant | 99 Merryknoll Rd, Weymouth, MA 02191-2020 | 2020-09-30 |
| 1942812334 | Manacey Clermont | Physician Assistant | 21 Robinson Rd, Woburn, MA 01801-6136 | 2020-08-18 |
| 1801411756 | Kimberly Marques | Physician Assistant | 3 Medeiros Farm Rd, Seekonk, MA 02771-2029 | 2020-06-16 |
| 1821613548 | Emily Reynolds | Physician Assistant | 7 Blood Rd, Charlton, MA 01507-5128 | 2020-06-09 |
| 1275155590 | Makenna Camara | Physician Assistant | 249 Hixville Rd, North Dartmouth, MA 02747-1937 | 2020-05-08 |
| 1720608912 | John Eastman | Physician Assistant | 243b Savin Hill Ave, Boston, MA 02125-1003 | 2020-04-17 |
| 1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
| 1366074122 | Heather Kirby | Physician Assistant | 264 Fowler Rd, Westfield, MA 01085-4013 | 2020-02-10 |
| 1639712011 | Joseph John Milos | Physician Assistant | 201 Carlson Ln, West Barnstable, MA 02668-1224 | 2019-10-18 |
| 1912558321 | Rafael Rondeau | Physician Assistant | 12 Indian Pond Rd, Kingston, MA 02364-2051 | 2019-09-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.