Provider Demographics
NPI:1881858884
Name:ZOOK, MARY ELIZABETH (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:ZOOK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:875 BEACON ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3874
Mailing Address - Country:US
Mailing Address - Phone:617-521-1002
Mailing Address - Fax:617-521-3467
Practice Address - Street 1:94 PILGRIM RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-4127
Practice Address - Country:US
Practice Address - Phone:617-521-1002
Practice Address - Fax:617-521-3467
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA106417363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health