Moore, Mary-Ellin
Moore, Mary-Ellin is an individual health care provider with primary practice located at 83 Littlefield Rd , Newton MA 02459-3010. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Moore, Mary-Ellin can be contacted via phone (617) 928-1530.Contact Information
Primary practice address
83 Littlefield Rd
Newton MA 02459-3010
Phone: (617) 928-1530
Fax: (617) 928-1531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 160595 | Massachusetts |
Profile Details
| NPI number | 1689618720 |
|---|---|
| LBN Legal business name | Moore, Mary-Ellin |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689618720 | NPPES |
| Massachusetts | Other | NP4210 | BC/BS PROVIDER NUMBER |
| Massachusetts | MEDICAID | 0327484 | BC/BS PROVIDER NUMBER |
| Massachusetts | Other | P00043183 | BC/BS PROVIDER NUMBER |
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