AGAPE MEDICAL SPA (NPI# 1376739441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376739441 |
| Entity Type | Organization |
| Organization Name | AGAPE MEDICAL SPA |
| Other Organization Name | AGAPE DERMATOLOGY |
| Practice Address |
775 Davol St Fall River MA 02720-1028 |
| Practice Telephone | 5086744000 |
| Practice Fax Number | 5086748880 |
| Mailing Telephone | 5086744000 |
| Mailing Fax Number | 5086748880 |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | PAUL MALLARI (OWNER) |
| Authorized Official Telephone | 5086744000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1919 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Agape Dermatology | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | AGAPE MEDICAL SPA AND WEIGHT LOSS CENTER, LLC | 191 Bedford St., Fall River, MA 02720 |
| Street Address |
775 DAVOL ST |
| City | FALL RIVER |
| State | MA |
| Zip Code | 02720-1028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356960264 | Robert Walsh | Massage Therapist | 275 High Street, 1st Floor Rear, Fall River, MA 02720 | 2020-04-10 |
| 1487147252 | Patricia Mateus Peterson | Social Worker | 1561 N Main Street, Fall River, MA 02720 | 2018-06-07 |
| 1669980371 | Jolita Perez | Home Health Aide | 92 Hanover St Apt 2, Fall River, MA 02720 | 2018-01-16 |
| 1023537305 | Rebekah Shermer Woolf | Counselor | 1082 Davol St., Fall River, MA 02720 | 2017-09-18 |
| 1467977843 | Elena Amelia Cetola | Nurse Practitioner | 38 Rock St Ste 2, Fall River, MA 02720 | 2017-08-07 |
| 1477903128 | Rebecca Anne Weller | Counselor | 1082 Davol St, Fall River, Ma 02720, Fall River, MA 02720 | 2016-06-14 |
| 1811358773 | Tiana Vidal | Counselor | 1082 N Davol St., Fallriver, MA 02720 | 2016-03-18 |
| 1477925907 | David Vega | Counselor | 1082 N Davol St, Fall River, MA 02720 | 2015-10-23 |
| 1235537473 | Desire Hendricksmoreno | Counselor | 279 North Main Street, Fall River, MA 02720 | 2014-12-19 |
| 1801294160 | Rebecca Bergeron | Counselor | 1080 Davol Street, Suite 202, Fall River, MA 02720 | 2014-12-18 |
| Find all providers in zip 02720 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477619344 | Kevin Harkins | Physician Assistant | 102 County St, Fall River, MA 02723-2104 | 2006-12-28 |
| 1194808691 | Dan Kim Nguyen | Physician Assistant | 528 Newton Street, Tru-med Walk-in, Fall River, MA 02721 | 2006-10-20 |
| 1306945746 | Jason Haas | Physician Assistant | 289 Plesant Street, Fall River, MA 02721 | 2006-09-22 |
| 1245234517 | Lynne A Bisbano | Physician Assistant | 1030 President Avenue Suite 104, Southcoast Physician Services, Inc., Fall River, MA 02720-5929 | 2005-06-02 |
| 1306481270 | Lauren Theresa Stanley | Physician Assistant | 795 Middle St, Fall River, MA 02721-1733 | 2019-11-14 |
| 1407417116 | Keya Thakkar | Physician Assistant | 277 Pleasant St Ste 101, Fall River, MA 02721-3005 | 2019-06-24 |
| 1891269585 | Emily Autumn Cambrola | Physician Assistant | 277 Pleasant St Ste 101, Fall River, MA 02721-3005 | 2019-01-15 |
| 1518482827 | Tyler Hill | Physician Assistant | 1601 S Main St, Fall River, MA 02724-2107 | 2017-08-08 |
| 1114309788 | Richa Magan | Physician Assistant | 277 Pleasant St, Suite 202, Fall River, MA 02721-3005 | 2015-06-19 |
| 1184035735 | Kelly Jo Brigham | Physician Assistant | 528 Newton St, Fall River, MA 02721-2366 | 2014-05-16 |
| Find all providers in FALL RIVER | ||||
| City | FALL RIVER |
| Zip Code | 02720 |
Please comment or provide details below to improve the information on AGAPE MEDICAL SPA.
| 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.