Provider Demographics
NPI:1255458840
Name:FINGUERRA, LINDA THERESA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:THERESA
Last Name:FINGUERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:FINGUERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN,BC
Mailing Address - Street 1:27 KILBURN RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1611
Mailing Address - Country:US
Mailing Address - Phone:617-467-4253
Mailing Address - Fax:
Practice Address - Street 1:8 ALTON PL
Practice Address - Street 2:SUITE 5
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6447
Practice Address - Country:US
Practice Address - Phone:617-232-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121188363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPN0308OtherBCBS PROVIDER NUMBER