Individual
MARIANNE BALSAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
1250 HANCOCK ST, QUINCY, MA 02169-4339
(617) 774-0920
Mailing address
147 MILK ST, PROVIDER ENROLLMENT, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
96414
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN0583
BLUE CROSS
MA
Enumeration date
05/12/2006
Last updated
03/04/2009
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