Individual
TERESA ANN DIMODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP-C, RN
Contact information
Practice address
1 HARBORSIDE DR, BOSTON, MA 02128-2907
(844) 977-3725
Mailing address
45 DESOTO RD, WEST ROXBURY, MA 02132-6004
(617) 910-7970
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2267894
MA
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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