Individual
KOMAL KENKARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
220 RESERVOIR ST STE 21, NEEDHAM, MA 02494-3133
(781) 449-1143
(781) 449-5992
Mailing address
220 RESERVOIR ST STE 21, NEEDHAM, MA 02494-3133
(781) 449-1143
(781) 449-5992
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2300320
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2300320
NURSE PRACTITIONER LICENSE NUMBER
MA
Enumeration date
07/15/2016
Last updated
02/20/2020
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