Individual
JILLIAN DECOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 JFK ST, CAMBRIDGE, MA 02138-4909
(617) 354-4420
Mailing address
6 JFK ST, CAMBRIDGE, MA 02138-4909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2302562
MA
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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