Healthcare Provider Details

I. General information

NPI: 1831024413
Provider Name (Legal Business Name): REANNA AZIZA CADER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

325 COMMANDANTS WAY APT 431
CHELSEA MA
02150-4082
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2000
  • Fax:
Mailing address:
  • Phone: 845-401-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN2367032
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: