Individual
MARYORI CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 BOSTON MEDICAL CTR PL DEPT OF, DEPARTMENT OF ANESTHESIA, BOSTON, MA 02118-2908
(617) 638-6950
(617) 638-6966
Mailing address
801 ALBANY ST, FL G, BOSTON, MA 02119
(617) 414-5405
(617) 414-6031
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2263862
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110125123A
—
MA
Enumeration date
01/19/2010
Last updated
10/06/2020
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