Individual
MRS. KRISTIN LOUISE MANGADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 BROOKLINE AVE, D315, BOSTON, MA 02215-5418
(617) 632-3796
Mailing address
89 WALTHAM ST, WEST NEWTON, MA 02465-1327
(914) 439-3859
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
246649
MA
Other
Enumeration date
12/11/2006
Last updated
07/21/2011
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