MARY S BANNON NP
NPI 1043392590
Nurse Practitioner - Gerontology in Waltham, MA

Q: What is Mary Bannon's NPI number?

The NPI number for Mary Bannon is 1043392590. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Q: What is Mary Bannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Mary Bannon was last updated on July 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2006

671 MAIN ST, WALTHAM, MA 02451(781) 647-3040(781) 647-3044 Get Directions Write a Review

NPPES record last updated: July 28, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mary S Bannon Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY S BANNON NP (NPI 1043392590) is an individual gerontology provider in Waltham, Massachusetts, licensed in Massachusetts (158347) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1043392590

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMARY S BANNONCredential: NP

Location Address671 MAIN STWaltham, MA 02451-0602

Mailing Address47 High Street Suite 101North Andover, MA 01845 · (978) 685-2460 · Fax (978) 685-2572

Phone(781) 647-3040

Fax(781) 647-3044

Sole ProprietorNo

Enumeration DateOctober 20, 2006

Last NPPES UpdateJuly 28, 2017

✔ NPI 1043392590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MA · 158347

671 MAIN ST, Waltham, MA 02451

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN FRANCHI NP

Nurse Practitioner

671 MAIN ST
WALTHAM, MA 02451

Middlesex County (781) 647-3040

DR. W. VINCENT PERRELLI MD

Internal Medicine (Geriatric Medicine)

671 MAIN ST
WALTHAM, MA 02451

Middlesex County (781) 647-3040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Bannon's NPI number?

The NPI number for Mary Bannon is 1043392590. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Where is Mary Bannon located?

Mary Bannon practices at 671 Main St, Waltham, MA 02451. The listed phone number is (781) 647-3040.

What is Mary Bannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Mary Bannon was last updated on July 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.