Provider Demographics
NPI:1730112962
Name:NATICK VISITING NURSE ASSN
Entity Type:Organization
Organization Name:NATICK VISITING NURSE ASSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-653-3081
Mailing Address - Street 1:209 WEST CENTRAL STREET
Mailing Address - Street 2:SUITE 313
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3759
Mailing Address - Country:US
Mailing Address - Phone:508-653-3081
Mailing Address - Fax:508-653-8276
Practice Address - Street 1:209 WEST CENTRAL STREET
Practice Address - Street 2:SUITE 313
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3759
Practice Address - Country:US
Practice Address - Phone:508-653-3081
Practice Address - Fax:508-653-8276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA602137OtherAETNA
MA1509OtherCARE CENTRIX
MA19356OtherFALLON
MA800877OtherTUFTS HEALTH PLAN
MA0602035Medicaid
MA120079OtherBLUE CROSS BLUE SHIELD
MA7000000004OtherHARVARD PILGRIM HEALTH CA
MA602137OtherAETNA
MA602137OtherAETNA