MEDICARE: MS. ELEONORA AZENSTEIN 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
1	363LF0000X	Family Nurse Practitioner	RN2264132	MA

General Provider Information

NPI Number	:	1982983292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELEONORA AZENSTEIN NP

Provider Business Mailing Address
First Line	:	65 WALNUT ST STE 330
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2154
Country	:	US
Telephone Number	:	617-630-0380
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 WALNUT ST STE 330
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2154
Country	:	US
Telephone Number	:	617-875-9325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	11/29/2023

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