Individual
MR. TORY LEIF LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, NP
Contact information
Practice address
872 MASS AVE, APT 503, CAMBRIDGE, MA 02139-3073
(973) 919-4816
Mailing address
872 MASS AVE, APT 503, CAMBRIDGE, MA 02139-3073
(973) 919-4816
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2308024
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110122144A
—
MA
Enumeration date
09/13/2016
Last updated
06/21/2023
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