Individual
MS. CARLA LYNN MONGIACOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
77 HASTRUP ROAD, SPENCER, MA 01562
(774) 262-3513
(508) 885-5048
Mailing address
425 OAKHILL ROAD, FITCHBURG, MA 01420
(857) 413-7103
(508) 885-5048
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
214054
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0707341
MASS HEALTH
MA
Enumeration date
03/20/2007
Last updated
07/08/2007
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