Healthcare Provider Details

I. General information

NPI: 1184006603
Provider Name (Legal Business Name): MARGARET SONG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2015
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST CWN L-1
BOSTON MA
02115
US

IV. Provider business mailing address

75 FRANCIS ST CWN L-1
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-525-9542
  • Fax: 617-732-7100
Mailing address:
  • Phone: 617-525-9542
  • Fax: 617-732-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN204816
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2366938
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: