Healthcare Provider Details

I. General information

NPI: 1427059021
Provider Name (Legal Business Name): CINDY MUNRO POPOVIC APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDWAY RD
MILFORD MA
01757-2923
US

IV. Provider business mailing address

9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US

V. Phone/Fax

Practice location:
  • Phone: 508-634-7338
  • Fax: 508-634-7315
Mailing address:
  • Phone: 508-553-3583
  • Fax: 508-634-7315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number002532
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN208893
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: