Individual
DR. MARVELA GRATIA HERMANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
850 N MAIN STREET EXT STE 2A2, WALLINGFORD, CT 06492-2483
(203) 626-5581
Mailing address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2209
MA
213E00000X
Podiatrist
DPM00314
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0322016
—
MA
01
—
29310-1/412354
BLUE CROSS BLUE SHIELD
RI
01
—
480031933
MEDICARE RAILROAD
—
05
—
MH48662
—
RI
01
—
Y71109
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/28/2006
Last updated
05/15/2026
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