Provider Demographics
NPI:1427035518
Name:TULIO, MARY E (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:TULIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1200
Mailing Address - Fax:781-340-1610
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1200
Practice Address - Fax:781-340-1610
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA172898363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3414OtherBLUE CROSS BLUE SHIELD
MANP3414Medicare PIN
MANP3414OtherBLUE CROSS BLUE SHIELD