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General NPI Number Information
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NPI Number | 1255247763
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Entity Type | Individual
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Provider Name | MARY NAKUYA RN
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 266 RESERVOIR AVE
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City | REVERE
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State | MA
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Zip | 02151-5812
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Country | US
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Telephone | 781-552-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 266 RESERVOIR AVE
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City | REVERE
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State | MA
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Zip | 02151-5812
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Country | US
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Telephone | 781-552-6010
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN10047092
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License Number State | MA
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