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NPI Code Detail

MEDICARE: ANGELA KASUMOVA

MEDICARE: ANGELA KASUMOVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1073766929
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA KASUMOVA
Provider Business Mailing Address
First Line : 6 SOUTHSIDE RD
Second Line :
City : DANVERS
State : MA
Zip : 01923-1409
Country : US
Telephone Number : 978-762-8352
Fax Number :
Provider Business Practice Location Address
First Line : 6 SOUTHSIDE RD
Second Line :
City : DANVERS
State : MA
Zip : 01923-1409
Country : US
Telephone Number : 978-762-8352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 09/04/2014

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Directions to “ ANGELA KASUMOVA ” Practice Location

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