Individual
MARY E CAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
(781) 306-5379
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
176836
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
176836
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360741
—
MA
01
—
39164
HARARD PILGRIM
MA
01
—
NP1114
BLUE CROSS
MA
Enumeration date
03/31/2006
Last updated
01/05/2021
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