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Individual

MR. JUSTIN EUSEBIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, RN, PMHNP-BC

Contact information

Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 595-1115
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2320812
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2320812
MA

Other

Enumeration date
07/18/2019
Last updated
01/08/2020
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