Individual
MRS. TRACEY ANNE COSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
3 AMBER WAY, GROVELAND, MA 01834-2108
(978) 377-0592
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
211483
MA
Other
Enumeration date
06/15/2006
Last updated
06/15/2008
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