Healthcare Provider Details

I. General information

NPI: 1518835412
Provider Name (Legal Business Name): TARA KAUR AHLUWALIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WELLESLEY ST STE 1
WESTON MA
02493-1571
US

IV. Provider business mailing address

140 ARSENAL ST UNIT 2335
WATERTOWN MA
02472-2951
US

V. Phone/Fax

Practice location:
  • Phone: 781-768-7000
  • Fax:
Mailing address:
  • Phone: 207-838-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN2363949
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: