Individual
MR. DAVID J DEROSIER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG, CPNP-AC
Contact information
Practice address
55 LAKE AVE N, PEDIATRIC CRITICAL CARE, WORCESTER, MA 01655-0002
(774) 442-2164
(774) 443-2062
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN269379
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN269379
MA
363LP0200X
Pediatric Nurse Practitioner
RN269379
MA
Other
Enumeration date
06/05/2020
Last updated
12/12/2025
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