Healthcare Provider Details

I. General information

NPI: 1992625107
Provider Name (Legal Business Name): ASHLEY G MASTRULLO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 INGALLS CT
MEUTHEN MA
01844
US

IV. Provider business mailing address

31 DANVILLE RD
KINGSTON NH
03848-3405
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-2807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN10048338
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: