| Doctor Name: | MARY A. BERUBE |
| NPI Number: | 1194716076 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 011346-23-05 |
| Business Practice Address: | 52 High St New Boston, NH - 030704027 |
| Business Phone Number: | 6034873429 |
| Business Fax Number: | 6034872103 |
| Mailing Address: | 52 High St, NEW BOSTON |
| State: | NH |
| Postal Code: | 030704027 |
| Phone Number: | 6034873429 |
| Fax Number: | 6034872103 |
| NPI Enumeration Date: | 10/31/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 011346-23-05 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |