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Individual
ALICIA PAVADORE
Active
Individual
ALICIA PAVADORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7963
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110170436A
—
MA
05
—
3128741
—
NH
Enumeration date
06/03/2020
Last updated
06/01/2023
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