Provider Demographics
NPI:1770862088
Name:ARUDA, MARY MARGARET (PHD, PNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARET
Last Name:ARUDA
Suffix:
Gender:F
Credentials:PHD, PNP, FNP
Other - Prefix:
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Mailing Address - Street 1:100 MORRISSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3393
Mailing Address - Country:US
Mailing Address - Phone:617-287-5660
Mailing Address - Fax:617-287-3977
Practice Address - Street 1:100 MORRISSEY BLVD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02125-3393
Practice Address - Country:US
Practice Address - Phone:617-287-5660
Practice Address - Fax:617-287-3977
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN145284363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics