Basic Information
| Provider Information | |||||||||
| NPI: | 1639829880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AKINTAN | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | OLUWABAMIKE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 WOODSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | RUTLAND | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015431484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7746412444 | ||||||||
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| Practice Location | |||||||||
| Address1: | 72 JAQUES AVE | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088601154 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2022 | ||||||||
| LastUpdateDate: | 03/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | RN2298922 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.