Individual
KEVIN VACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-1461
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NR20805400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2384402
MA
Other
Enumeration date
04/30/2022
Last updated
08/11/2023
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