Provider Demographics
NPI:1629807607
Name:MASCARENHAS, KHADY
Entity type:Individual
Prefix:
First Name:KHADY
Middle Name:
Last Name:MASCARENHAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2703
Mailing Address - Country:US
Mailing Address - Phone:857-243-1407
Mailing Address - Fax:
Practice Address - Street 1:111 WHITE ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2703
Practice Address - Country:US
Practice Address - Phone:857-243-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty