Provider Demographics
NPI:1326485962
Name:TEI, CARA RENEE
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:RENEE
Last Name:TEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WINTER ST
Mailing Address - Street 2:APT 10
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3850
Mailing Address - Country:US
Mailing Address - Phone:617-949-0081
Mailing Address - Fax:
Practice Address - Street 1:17 WINTER ST
Practice Address - Street 2:APT 10
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3850
Practice Address - Country:US
Practice Address - Phone:617-949-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2262737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse