Individual
DR. MARIO CORPUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
536 WASHINGTON ST, ABINGTON, MA 02351
(781) 871-3773
Mailing address
536 WASHINGTON STREET, ABINGTON, MA 02351
(781) 871-3773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN259608
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
259608
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110113802A
—
MA
Enumeration date
08/31/2012
Last updated
07/02/2016
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