Provider Demographics
NPI:1962632513
Name:HERMOSA RICE, MARGARITA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:
Last Name:HERMOSA RICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARGARITA
Other - Middle Name:
Other - Last Name:HERMOSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:93 POND ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2015
Mailing Address - Country:US
Mailing Address - Phone:781-784-9212
Mailing Address - Fax:781-784-7671
Practice Address - Street 1:33 BOW STREET
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143
Practice Address - Country:US
Practice Address - Phone:617-625-9992
Practice Address - Fax:617-666-0662
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN280211163W00000X
MA280211163W00000X
MA104345324363LX0001X
MA2009005642363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology