Healthcare Provider Details

I. General information

NPI: 1497279830
Provider Name (Legal Business Name): ALEXANDRA MAY CAVALLARO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 WASHINGTON ST
HUDSON MA
01749-2765
US

IV. Provider business mailing address

171 MAIN ST STE 203B
ASHLAND MA
01721-1187
US

V. Phone/Fax

Practice location:
  • Phone: 978-562-0564
  • Fax: 978-562-5646
Mailing address:
  • Phone: 508-881-3029
  • Fax: 508-881-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2303110
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: