Healthcare Provider Details

I. General information

NPI: 1689693178
Provider Name (Legal Business Name): DONNA MORASH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE FEGAN 3
BOSTON MA
02115-5724
US

IV. Provider business mailing address

47 STANDISH RD
MILTON MA
02186-2851
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-2211
  • Fax: 617-355-0302
Mailing address:
  • Phone: 617-696-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number120125
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: