Individual
LAUREN B MANTIKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT STREET, BOSTON, MA 02241-9095
(860) 338-0354
Mailing address
55 FRUIT STREET, BOSTON, MA 02241-9095
(860) 338-0354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2351883
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN2351883
MA
Other
Enumeration date
09/23/2025
Last updated
01/13/2026
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