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Individual

MARTHA AYANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
I29409
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NP4299
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/10/2006
Last updated
06/14/2012
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