Provider Demographics
NPI:1619684792
Name:NALUNKUMA, FARIDAH NALUNKUMA (RN)
Entity Type:Individual
Prefix:
First Name:FARIDAH
Middle Name:NALUNKUMA
Last Name:NALUNKUMA
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 1:28 QUIMBY ST # 1
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4237
Mailing Address - Country:US
Mailing Address - Phone:617-259-8143
Mailing Address - Fax:
Practice Address - Street 1:28 QUIMBY ST # 1
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4237
Practice Address - Country:US
Practice Address - Phone:617-259-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2327816163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse