Unknown Individual – Nurse Practitioner, NPI 1679539704
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Harvard Vanguard, 147, Milk Street, Dock Square, Financial District, Boston, Suffolk County, Massachusetts, 02110, United States
PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON, MA 021094806
Phone: (617) 559-8374
Fax: (617) 421-3487
Type: Mailing
86, Baker Avenue Extension, West Concord, Concord, Middlesex County, Massachusetts, 01742, United States
CONCORD, MA 017422125
Phone: (978) 287-9300
Fax: (978) 287-9357
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02109)
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