Individual
MRS. MARCIE LEIGH DISTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
179 AUBURNDALE AVE, AUBURNDALE, MA 02466-1601
(617) 965-0414
Mailing address
179 AUBURNDALE AVE, AUBURNDALE, MA 02466-1601
(617) 965-0414
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN270591
MA
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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