Provider Demographics
NPI:1619357704
Name:MOBINI, AZITA (RN)
Entity Type:Individual
Prefix:
First Name:AZITA
Middle Name:
Last Name:MOBINI
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 1:6 HAWTHORNE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2711
Mailing Address - Country:US
Mailing Address - Phone:508-410-4288
Mailing Address - Fax:
Practice Address - Street 1:6 HAWTHORNE CIR
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2711
Practice Address - Country:US
Practice Address - Phone:508-410-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA631968163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health