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General NPI Number Information
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NPI Number | 1851321871
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Entity Type | Individual
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Provider Name | LORRAINE T RAVINO MAGNER NP
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1575 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-4308
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Country | US
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Telephone | 617-876-4344
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Fax | 617-234-7913
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Provider Business Mailing Address
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Address Line | 63 LORRAINE ST
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City | ROSLINDALE
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State | MA
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Zip | 02131-2733
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Country | US
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Telephone | 617-327-3742
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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 | MA231162
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License Number State | MA
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