Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 136577 | MA |
NPI | 1083992259 |
---|---|
Provider Name | Ms. Carol Ann Cirone |
First Address | Woburn, MA 01801 |
Second Address | Woburn, MA 01801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2011 |
Last Update Date | 27/10/2016 |