Provider Demographics
NPI:1376619601
Name:FURLONG, TARA M (CRNA)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:M
Last Name:FURLONG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:MICHELLE
Other - Last Name:FURLONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:311 ALBEMARLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1358
Mailing Address - Country:US
Mailing Address - Phone:617-304-5445
Mailing Address - Fax:617-795-0552
Practice Address - Street 1:BOSTON UNIVERSITY MEDICAL CENTER ANESTHESIOLOGISTS, INC
Practice Address - Street 2:1 BOSTON MEDICAL CTR PL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2908
Practice Address - Country:US
Practice Address - Phone:617-638-6950
Practice Address - Fax:617-638-6966
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217170367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110218053AMedicaid