MS. MARISSA ANN UDELSMAN (NPI# 1811322373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811322373 |
| Entity Type | Individual |
| Full Name | MS. MARISSA ANN UDELSMAN |
| Other Name | MARISSA ANN BOARDMAN |
| Credential | APRN |
| Practice Address |
30 Warren St Brighton MA 02135-3602 |
| Practice Telephone | 6172543800 |
| Mailing Telephone | 6172543800 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2016-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN2305855 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
30 WARREN ST |
| City | BRIGHTON |
| State | MA |
| Zip Code | 02135-3602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418085 | Wendy Ruth Cheney | Dentist | 30 Warren St, Brighton, MA 02135-3602 | 2005-06-23 |
| 1316545262 | Kimberly Paquette | Social Worker | 30 Warren St, Brighton, MA 02135-3602 | 2020-10-13 |
| 1154936318 | Annabelle M Collins | Student in an Organized Health Care Education/Training Program | 30 Warren St, Brighton, MA 02135-3602 | 2020-09-14 |
| 1881209047 | Natalie Gallo | Student in an Organized Health Care Education/Training Program | 30 Warren St, Brighton, MA 02135-3602 | 2020-09-14 |
| 1821603093 | Virginia Mahoney | Student in an Organized Health Care Education/Training Program | 30 Warren St, Brighton, MA 02135-3602 | 2020-09-14 |
| 1982217535 | Erin Straughn | Dietitian, Registered | 30 Warren St, Brighton, MA 02135-3602 | 2020-08-24 |
| 1992317101 | Jane Carper | Social Worker | 30 Warren St, Brighton, MA 02135-3602 | 2020-08-19 |
| 1235740473 | Ashley King | Social Worker | 30 Warren St, Brighton, MA 02135-3602 | 2020-08-12 |
| 1902417181 | Angelica Francesca Emery-fertitta | Social Worker | 30 Warren St, Brighton, MA 02135-3680 | 2020-08-12 |
| 1740891969 | Margaret Cecelia Vineis | Social Worker | 30 Warren St, Brighton, MA 02135-3602 | 2020-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699392944 | Nur Zeynep Ay | Student in an Organized Health Care Education/Training Program | 736 Cambridge Street St Elizabeths Medical Center, Graduate Medical Education (diane Giacalone), Boston, MA 02135 | 2020-07-02 |
| 1104470673 | Domenique Delucia | Counselor | 77f Warren Street, Brighton, MA 02135 | 2019-08-01 |
| 1831751684 | Meredith Mcghee | Audiologist | 736 Cambridge Street Smc-8, Brighton, MA 02135 | 2019-07-02 |
| 1730645847 | Delphine Alignol | Family Medicine | 330 Mount St, Cambridge, MA 02135 | 2019-02-13 |
| 1124501960 | Ellen Elizabeth Miller | Social Worker | 44 Mt Vernon St, Brighton, MA 02135 | 2018-09-07 |
| 1710466180 | Sharon Pae | Acupuncturist | 135 Chiswick Rd Bsmt, Brighton, MA 02135 | 2018-08-07 |
| 1750877155 | Leonid Sigal | Counselor | 9 South St Apt 2, Brighton, MA 02135 | 2018-07-09 |
| 1689165425 | Brian George Mcguire | Dentist | 24 Sidlaw Rd, Brighton, MA 02135 | 2018-05-29 |
| 1619467214 | Ashley Marie Arbuckle | Counselor | 77 Waren Street, Building 9, Brighton, MA 02135 | 2018-05-18 |
| 1871098962 | Arina Sorokina | Dentist | Charles River Community Health Center, 495 Western Avenue, Allston, MA 02135 | 2018-03-29 |
| Find all providers in zip 02135 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821318676 | Judith Jo Collica | Nurse Practitioner | 1021 Karl Greimel Dr Ste 100, Brighton, MI 48116-9465 | 2010-06-03 |
| 1841341559 | Tatum Sinclair | Nurse Practitioner | 77 Warren St Bldg 4, Brighton, MA 02135-3601 | 2007-01-16 |
| 1417921396 | Marian Amaranto | Nurse Practitioner | 183 S 18th Ave, Brighton, CO 80601-2472 | 2006-02-15 |
| 1649809765 | Aimee Carew- Lyons | Nurse Practitioner | 30 Warren St, Brighton, MA 02135-3602 | 2020-04-02 |
| 1730726126 | Alyssa Sue Fraser | Nurse Practitioner | 2305 Genoa Business Park Dr Ste 240, Brighton, MI 48114-7005 | 2019-12-04 |
| 1356903991 | Mary Laurette Hughes | Nurse Practitioner | 30 Warren St, Brighton, MA 02135-3602 | 2019-07-03 |
| 1063990950 | Lisa Ngu | Nurse Practitioner | 495 Western Ave, Brighton, MA 02135-1007 | 2018-08-01 |
| 1467828343 | Bipin Desai Md | Nurse Practitioner | 136 Kissane Ave, Brighton, MI 48116-2467 | 2015-08-14 |
| 1245653005 | Stephanie Louise Hopkins | Nurse Practitioner | 30 Warren St, Brighton, MA 02135-3602 | 2014-01-30 |
| 1265865091 | Amelia Joy Massimini | Nurse Practitioner | 30 Warren St, Brighton, MA 02135-3602 | 2013-08-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.