Basic Information
Provider Information
NPI: 1891008660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PUNTURIERO
FirstName: JAYNA
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: MSW, MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 29 N MAIN ST
Address2:  
City: FLORENCE
State: MA
PostalCode: 010621287
CountryCode: US
TelephoneNumber: 4135865555
FaxNumber: 4135862723
Practice Location
Address1: 29 N MAIN ST
Address2:  
City: FLORENCE
State: MA
PostalCode: 010621287
CountryCode: US
TelephoneNumber: 4135865555
FaxNumber: 4135862723
Other Information
ProviderEnumerationDate: 07/21/2010
LastUpdateDate: 07/21/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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