Provider Demographics
NPI:1952168940
Name:MASSA, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:MASSA
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 1:139 WASHINGTON ST, APT 628
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON-BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-938-9460
Mailing Address - Fax:
Practice Address - Street 1:139 WASHINGTON ST, APT 628
Practice Address - Street 2:
Practice Address - City:BRIGHTON-BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-938-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula