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NPI Code Detail

MEDICARE: NHA MY QUACH NP

MEDICARE: NHA MY QUACH NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner250450MA

General Provider Information

NPI Number : 1225208432
Entity Type Code : Individual
Provider Name (Legal Business Name) : NHA MY QUACH NP
Provider Business Mailing Address
First Line : 145 SOUTH ST
Second Line :
City : BOSTON
State : MA
Zip : 02111-2826
Country : US
Telephone Number : 617-482-7555
Fax Number : 617-482-2930
Provider Business Practice Location Address
First Line : 885 WASHINGTON ST
Second Line :
City : BOSTON
State : MA
Zip : 02111-1415
Country : US
Telephone Number : 617-482-7555
Fax Number : 617-482-2930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2008
Last Update Date : 03/04/2008

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