Individual
KATHLEEN BLACK TENEROWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 288-3230
(617) 825-4972
Mailing address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 288-3230
(617) 825-4972
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2269719
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110022129
—
MA
Enumeration date
10/31/2013
Last updated
04/05/2017
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