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NPI Code Detail

MEDICARE: HEEKYEONG MA NP-C

MEDICARE: HEEKYEONG MA NP-C
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
1363L00000XNurse PractitionerRN266575MA

General Provider Information

NPI Number : 1649949777
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEEKYEONG MA NP-C
Provider Business Mailing Address
First Line : 226 POND ST UNIT 3
Second Line :
City : NATICK
State : MA
Zip : 01760-4376
Country : US
Telephone Number : 781-715-5632
Fax Number :
Provider Business Practice Location Address
First Line : 31 PINE ST STE 204
Second Line :
City : NORFOLK
State : MA
Zip : 02056-1680
Country : US
Telephone Number : 617-739-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2021
Last Update Date : 12/01/2025

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Directions to “ HEEKYEONG MA NP-C” Practice Location

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