Healthcare Provider Details

I. General information

NPI: 1881519254
Provider Name (Legal Business Name): TAICHA VALBRUNE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 FULTON ST
BOSTON MA
02109-1402
US

IV. Provider business mailing address

26 MAIN ST
EDISON NJ
08837-3418
US

V. Phone/Fax

Practice location:
  • Phone: 617-843-5001
  • Fax:
Mailing address:
  • Phone: 732-813-6793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN2378668
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: