Basic Information
| Provider Information | |||||||||
| NPI: | 1447660246 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KASLOW | ||||||||
| FirstName: | LORA | ||||||||
| MiddleName: | SUSAN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 192 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018101822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789376000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 192 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018101822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789376000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2014 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 271828 | MA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | RN271828 | MA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.