MEDICARE: CLAIRE TONGKAEW APRN, FNP-BC

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
1	363L00000X	Nurse Practitioner	RN2350970	MA
2	363LF0000X	Family Nurse Practitioner	RN2350970	MA

General Provider Information

NPI Number	:	1720893993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE TONGKAEW APRN, FNP-BC

Provider Business Mailing Address
First Line	:	500 COMMONWEALTH AVE # 526
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-2606
Country	:	US
Telephone Number	:	224-289-6915
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 ERIN WAY
Second Line	:
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-2832
Country	:	US
Telephone Number	:	224-289-6915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	08/15/2025

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