Healthcare Provider Details

I. General information

NPI: 1053992925
Provider Name (Legal Business Name): NINA LUCIA TAMASHUNAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 CAMBRIDGE RD STE 310
WOBURN MA
01801-6078
US

IV. Provider business mailing address

304 CAMBRIDGE RD STE 310
WOBURN MA
01801-6078
US

V. Phone/Fax

Practice location:
  • Phone: 781-272-7022
  • Fax:
Mailing address:
  • Phone: 781-272-7022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1026301
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: