Healthcare Provider Details

I. General information

NPI: 1306707807
Provider Name (Legal Business Name): EMMA O'TOOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 WILLARD ST STE 400
QUINCY MA
02169-7469
US

IV. Provider business mailing address

859 WILLARD ST STE 400
QUINCY MA
02169-7469
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-3875
  • Fax:
Mailing address:
  • Phone: 508-233-3875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2327050
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2327050
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: