Basic Information
| Provider Information | |||||||||
| NPI: | 1902061153 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUFFAM | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 851 MAIN ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021901613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818122701 | ||||||||
| FaxNumber: | 6176876414 | ||||||||
| Practice Location | |||||||||
| Address1: | 1261 FURNACE BROOK PKWY STE 31 | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021694768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174797757 | ||||||||
| FaxNumber: | 6174794555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2008 | ||||||||
| LastUpdateDate: | 06/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | RN267642 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.