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Individual

FALISHA PORTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
55 FRUIT ST, MASS GENERAL HOSPITAL WANG 460, BOSTON, MA 02114-1507
(781) 510-9459
Mailing address
324 CANTON ST, RANDOLPH, MA 02368-1507
(781) 510-9459

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
281011
MA
363L00000X
Nurse Practitioner
Primary
RN281011
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RN 281011
MA
Enumeration date
12/07/2015
Last updated
01/18/2017
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