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General NPI Number Information
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NPI Number | 1295624047
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Entity Type | Individual
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Provider Name | MOZART M. TELLES NP
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Gender | Male
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Dates
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Enumeration Date | 06/28/2025
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Last Update Date | 06/28/2025
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Provider Practice Location Address
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Address Line | 30 DOUGLAS HILL WAY
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City | DOUGLAS
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State | MA
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Zip | 01516-2257
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Country | US
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Telephone | 508-941-6785
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Fax |
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Provider Business Mailing Address
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Address Line | 30 DOUGLAS HILL WAY
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City | DOUGLAS
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State | MA
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Zip | 01516-2257
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Country | US
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Telephone | 508-941-6785
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN2349458
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License Number State | MA
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