Healthcare Provider Details

I. General information

NPI: 1477642684
Provider Name (Legal Business Name): LUCRETIA STEITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S HUNTINGTON AVE
BOSTON MA
02130-4893
US

IV. Provider business mailing address

150 S HUNTINGTON AVE
BOSTON MA
02130-4817
US

V. Phone/Fax

Practice location:
  • Phone: 857-364-4223
  • Fax: 857-364-4421
Mailing address:
  • Phone: 857-364-4223
  • Fax: 857-364-4421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number271822
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: