Provider Demographics
NPI:1669018370
Name:DIMAURO, ASHLEY ERIN
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ERIN
Last Name:DIMAURO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FEDERAL ST STE 700
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1727
Mailing Address - Country:US
Mailing Address - Phone:844-341-2339
Mailing Address - Fax:
Practice Address - Street 1:155 FEDERAL ST STE 700
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1727
Practice Address - Country:US
Practice Address - Phone:844-341-2339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2311821363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology