Provider Demographics
NPI:1568583565
Name:COMERFORD, MARILYN GAYE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:GAYE
Last Name:COMERFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BRIARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-1102
Mailing Address - Country:US
Mailing Address - Phone:781-767-0222
Mailing Address - Fax:
Practice Address - Street 1:14 BRIARWOOD RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-1102
Practice Address - Country:US
Practice Address - Phone:781-767-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133404163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0312002OtherPROVIDER NUMBER