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General NPI Number Information
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NPI Number | 1952262859
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Entity Type | Organization
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Legal Business Name | MYSTIC VALLEY SEXUAL WELLNESS, PC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 802 MAIN ST LOWR LEVEL
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City | MELROSE
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State | MA
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Zip | 02176-2708
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Country | US
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Telephone | 617-996-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 802 MAIN ST LOWR LEVEL
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City | MELROSE
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State | MA
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Zip | 02176-2708
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Country | US
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Telephone | 617-996-5800
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MAGEN PRICE
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Credential | FNP-BC
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Telephone | 617-447-3018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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