Healthcare Provider Details

I. General information

NPI: 1316694581
Provider Name (Legal Business Name): MORLAI ADIKALI TURAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 ENNELL ST
LOWELL MA
01850-1815
US

IV. Provider business mailing address

99 ENNELL ST
LOWELL MA
01850-1815
US

V. Phone/Fax

Practice location:
  • Phone: 978-758-6152
  • Fax:
Mailing address:
  • Phone: 978-758-6152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN2330553
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: