MICHELLE EJIOFOR (NPI# 1942586292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942586292 |
| Entity Type | Individual |
| Full Name | MICHELLE EJIOFOR |
| Other Name | MICHELLE GRAEFF |
| Practice Address |
680 Centre St Brockton MA 02302-3308 |
| Mailing Address |
10 Pompeii St Apt 2 Boston MA 02119-2918 |
| Practice Telephone | 7172228138 |
| Mailing Telephone | 7172228138 |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
C0004561 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA4550 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
680 CENTRE ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02302-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176910 | Marcia Waitzman | Obstetrics & Gynecology | 680 Centre St, Brockton, MA 02302-3308 | 2005-07-01 |
| 1770196396 | Samantha Lipsky | Physician Assistant | 680 Centre St, Brockton, MA 02302-3308 | 2020-08-24 |
| 1760009328 | Mandi Ella Clegg | Social Worker | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-30 |
| 1972128643 | Matthew Hall Wilson | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1679198493 | Alyssa Dicosmo | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1720603566 | Tessie Allan | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1588289375 | Collin Rozanski | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1619592417 | Balaji Arun Jothishankar | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1013532845 | Angell Shi | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1386269124 | Rebecca Yanovsky | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1578055505 | Steigmward Desir | Specialist | 472 E Ashland St, Brockton, MA 02302 | 2018-06-05 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700303856 | My Care, LLC | Home Health | 307 Field Street, Brockton, MA 02302 | 2017-08-29 |
| 1982124988 | Shavon Franks | Psychologist | 30 Downey Rd, Brockton, MA 02302 | 2017-06-21 |
| 1831629286 | Kings & Queens Empowered | Religious Nonmedical Health Care Institution | 312 Carl Ave, Brockton, MA 02302 | 2017-06-18 |
| 1487193389 | Roseline Eliezer | Licensed Practical Nurse | 17 Simeon Avenue, Brockton, MA 02302 | 2017-02-13 |
| 1184008989 | Danielle Parker | Student in an Organized Health Care Education/Training Program | 23 Grinnell Rd, Brockton, MA 02302 | 2015-07-13 |
| Find all providers in zip 02302 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477195089 | Alexis Heather Chen | Physician Assistant | 680 Centre St, Brockton, MA 02302-3395 | 2019-10-15 |
| 1316311723 | Matthew K. Haga | Physician Assistant | 680 Centre St, Brockton, MA 02302-3308 | 2015-11-23 |
| 1508257478 | Chelsea K. Champlin | Physician Assistant | 1 Pearl St, Suite 2000, Brockton, MA 02301-2864 | 2015-02-12 |
| 1588096655 | Shawna Mae Bucchere | Physician Assistant | 1 Pearl St, Suite 2100, Brockton, MA 02301-2864 | 2013-07-31 |
| 1790828119 | Timothy D Grinnell | Physician Assistant | 110 Liberty St, Brockton, MA 02301-5521 | 2007-02-15 |
| 1265417042 | James Vincent Sauro | Physician Assistant | 110 Liberty St, Brockton, MA 02301-5521 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627106 | Taia Maria Tieland | Physician Assistant | 9 Hunting St Apt 1, Cambridge, MA 02141-1010 | 2020-07-24 |
| 1003434275 | Antonious Jonah Abraham | Physician Assistant | 99 Corn Rd, Bolton, MA 01740-1055 | 2020-07-13 |
| 1407479272 | Mackenzie Malcolm Gray | Physician Assistant | 35 Pynchon Rd, Holyoke, MA 01040-1514 | 2020-05-27 |
| 1780235333 | Emily Fregeau | Physician Assistant | 1 Canal St Unit 518, Boston, MA 02114-2053 | 2019-09-25 |
| 1992369524 | Jaclyn Hynes | Physician Assistant | 234 Otis St, Hingham, MA 02043-4504 | 2019-04-29 |
| 1376002931 | Jack City, LLC | Physician Assistant | 290 Pleasant St Apt 212, Watertown, MA 02472-2429 | 2019-03-13 |
| 1578021911 | Ashley Piemonte | Physician Assistant | 15 1/2 Russell St Apt 1, Charlestown, MA 02129-2492 | 2019-03-05 |
| 1407323686 | Nicole Burke Tingley | Physician Assistant | 123 Summer St Ste 277, Worcester, MA 01608-1216 | 2018-10-25 |
| 1386111706 | Nicole Laura Solman | Physician Assistant | 16 Deerhaven Rd, Lincoln, MA 01773-1806 | 2018-10-24 |
| 1881160943 | Philip Apraku Bondzie | Physician Assistant | 266 Sportsmans Trl, Whitman, MA 02382-1726 | 2018-10-16 |
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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.