Healthcare Provider Details

I. General information

NPI: 1013846096
Provider Name (Legal Business Name): ANIA DONAT MORTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 TYLER ST
METHUEN MA
01844-1905
US

IV. Provider business mailing address

176 EAST ST APT 205A
METHUEN MA
01844-5492
US

V. Phone/Fax

Practice location:
  • Phone: 857-261-6164
  • Fax:
Mailing address:
  • Phone: 857-261-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN10009626
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: