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General NPI Number Information
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NPI Number | 1871652099
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Entity Type | Individual
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Provider Name | MARY THERESA REED R.N., N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 159 UNION ST SUITE 103
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City | MARLBOROUGH
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State | MA
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Zip | 01752-1274
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Country | US
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Telephone | 508-624-9688
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Fax | 508-624-9689
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Provider Business Mailing Address
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Address Line | PO BOX 415358
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City | BOSTON
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State | MA
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Zip | 02241-5348
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Country | US
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Telephone | 508-334-1000
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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 | 150871
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License Number State | MA
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