Provider Demographics
NPI:1831158716
Name:GARBOSKI, MARY E (APRN BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:GARBOSKI
Suffix:
Gender:F
Credentials:APRN BC
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Mailing Address - Street 1:585 597 MERRIMACK STREET
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-934-0164
Mailing Address - Fax:978-452-2143
Practice Address - Street 1:15-17 WARREN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-934-0164
Practice Address - Fax:978-452-2143
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA137570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4473Medicare ID - Type Unspecified
Q09328Medicare UPIN