Healthcare Provider Details

I. General information

NPI: 1861530933
Provider Name (Legal Business Name): CHRISTINE A FOTI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 GARLAND ST CHA SENIOR CARE PROGRAM
EVERETT MA
02149-5066
US

IV. Provider business mailing address

103 GARLAND ST CHA SENIOR CARE PROGRAM
EVERETT MA
02149-5066
US

V. Phone/Fax

Practice location:
  • Phone: 617-394-7703
  • Fax:
Mailing address:
  • Phone: 617-394-7703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number132829
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: