Healthcare Provider Details

I. General information

NPI: 1689009094
Provider Name (Legal Business Name): NEWTON J HULL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE STREET CAMBRIDGE HEALTH HEALTH ALLIANCE
CAMBRIDGE STREET MA
02139
US

IV. Provider business mailing address

225 WATER STREET HEALTHCARE FOR HIRE
PLYMOUTH MA
02360
US

V. Phone/Fax

Practice location:
  • Phone: 508-732-9770
  • Fax:
Mailing address:
  • Phone: 508-732-9770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number59992
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: