Provider Demographics
NPI:1770515892
Name:DROOTIN, MARCIA (RN,MS,CS)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:DROOTIN
Suffix:
Gender:F
Credentials:RN,MS,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2831
Mailing Address - Country:US
Mailing Address - Phone:617-965-5944
Mailing Address - Fax:617-965-5944
Practice Address - Street 1:229 DUDLEY RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2831
Practice Address - Country:US
Practice Address - Phone:617-965-5944
Practice Address - Fax:617-965-5944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111087364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health