Individual
MERIDITH LEWIS MALYSZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-2731
(508) 856-1786
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN00182
RI
363L00000X
Nurse Practitioner
RN2275339
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205225273
—
RI
01
—
7090004048
MEDICARE GROUP PTAN
PW
Enumeration date
01/14/2015
Last updated
11/02/2021
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