Individual
MARK WAKSMONSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
12 MUDGE WAY, BEDFORD, MA 01730-2147
(781) 275-6507
Mailing address
PO BOX 659, LONDONDERRY, NH 03053-0659
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2282430
MA
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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