Healthcare Provider Details

I. General information

NPI: 1871974907
Provider Name (Legal Business Name): ANITA MARIE MEPANI AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 CHARLES ST
BOSTON MA
02114-3002
US

IV. Provider business mailing address

243 CHARLES ST
BOSTON MA
02114-3002
US

V. Phone/Fax

Practice location:
  • Phone: 617-573-3266
  • Fax: 617-573-3023
Mailing address:
  • Phone: 617-573-3266
  • Fax: 617-573-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1065
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: