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General NPI Number Information
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NPI Number | 1922169127
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Entity Type | Individual
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Provider Name | JOHN ROBERT NUGENT RN
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 52 SHARON ST PACT TEAM TRI CITY MENTAL HEALTH CENTER
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City | MALDEN
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State | MA
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Zip | 02148
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Country | US
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Telephone | 781-338-8800
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Fax | 781-397-2108
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Provider Business Mailing Address
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Address Line | 246 WEST STREET
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City | READING
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State | MA
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Zip | 01867
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Country | US
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Telephone | 781-944-4089
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 175275
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License Number State | MA
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