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General NPI Number Information
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NPI Number | 1649949777
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Entity Type | Individual
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Provider Name | HEEKYEONG MA NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/11/2021
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 31 PINE ST STE 204
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City | NORFOLK
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State | MA
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Zip | 02056-1680
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Country | US
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Telephone | 617-739-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 226 POND ST UNIT 3
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City | NATICK
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State | MA
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Zip | 01760-4376
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Country | US
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Telephone | 781-715-5632
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN266575
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License Number State | MA
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