Ketma Pericles

Licensed Practical Nurse · Cambridge, MA

Individual Active NPI

NPI number 1760119648

Practice location

1493 Cambridge St
Cambridge, MA 02139-1047
Phone
(781) 397-6546

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NPI record

NPI
1760119648
Entity type
Individual (Type 1)
Enumeration date
August 2, 2022
Last updated
August 2, 2022
Certified
August 2, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Licensed Practical Nurse Primary 164W00000X LN69424 MA

Mailing address

36 Tea Party Way
Malden, MA 02148-1980
Phone
(781) 922-1097

About Ketma Pericles

Ketma Pericles is a healthcare provider registered in the NPI registry with the primary taxonomy Licensed Practical Nurse (code 164W00000X). The practice location is 1493 Cambridge St, Cambridge, MA 02139-1047. The NPI number 1760119648 was assigned on August 2, 2022 and the record was last updated on August 2, 2022.

Ketma Pericles lists a license in the registry: #LN69424 (MA) for Licensed Practical Nurse. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ketma Pericles?

The NPI number is 1760119648.

What is the phone number of Ketma Pericles?

The phone number listed for the practice location is (781) 397-6546.

Where is Ketma Pericles located?

1493 Cambridge St, Cambridge, MA 02139-1047.

What is the taxonomy code for Ketma Pericles?

The primary taxonomy code is 164W00000X – Licensed Practical Nurse.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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