Provider Demographics
NPI:1558014027
Name:NDUATI, ALBERT (NURSE)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:NDUATI
Suffix:
Gender:M
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EMERSON RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1422
Mailing Address - Country:US
Mailing Address - Phone:781-558-6652
Mailing Address - Fax:
Practice Address - Street 1:5 EMERSON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1422
Practice Address - Country:US
Practice Address - Phone:781-558-6652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN91071164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse