Individual
MS. MARY C CASSIDY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
11 KENT ST, BROOKLINE, MA 02445-7901
(617) 447-2147
(617) 264-9763
Mailing address
90 READVILLE ST, BOSTON, MA 02136-2040
(617) 361-1173
(617) 361-1173
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
129190
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347001
—
MA
01
—
NP2539
BCBS
MA
Enumeration date
02/27/2006
Last updated
07/08/2007
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