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Individual

MRS. RYAN SULLIVAN TAMARGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
450 BROOKLINE AVE, BOSTON, MA 02215
(617) 632-3800
(617) 632-1930
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3800
(617) 632-1930

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2283429
MA
363LP2300X
Primary Care Nurse Practitioner
RN2283429
MA

Other

Enumeration date
09/14/2016
Last updated
10/26/2018
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