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General NPI Number Information
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NPI Number | 1215733597
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Entity Type | Individual
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Provider Name | KAYLA BANATOSKI
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 61 LINCOLN ST STE 203
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8264
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Country | US
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Telephone | 508-500-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 7 GREAT RD
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City | MAYNARD
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State | MA
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Zip | 01754-2016
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Country | US
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Telephone | 603-531-9424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2324891
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License Number State | MA
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