Provider Demographics
NPI:1003394396
Name:STONE, MARIANA (NP-C)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52A MONTAGUE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2508
Mailing Address - Country:US
Mailing Address - Phone:207-749-4138
Mailing Address - Fax:
Practice Address - Street 1:52A MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-2508
Practice Address - Country:US
Practice Address - Phone:207-749-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAF07181373207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine