Healthcare Provider Details

I. General information

NPI: 1609206739
Provider Name (Legal Business Name): CYNTHIA WAITE ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MOUNT AUBURN ST STE 410
CAMBRIDGE MA
02138-5665
US

IV. Provider business mailing address

330 MT AUBURN ST PARSONS 2
CAMBRIDGE MA
02138-5597
US

V. Phone/Fax

Practice location:
  • Phone: 617-868-2650
  • Fax: 617-868-2641
Mailing address:
  • Phone: 617-868-2650
  • Fax: 617-868-2641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2277292
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2277292
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2277292
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: