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Individual

DANIELA MARIE CICCOLINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000195893
TN
163W00000X
Registered Nurse
RN2270016
MA
363LP0200X
Pediatric Nurse Practitioner
18240
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2270016
MA

Other

Enumeration date
11/13/2013
Last updated
09/04/2019
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