Individual
DONNA D'AGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF SURGERY, WORCESTER, MA 01655-0002
(508) 856-5599
(508) 856-8329
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN155305
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0357634
—
MA
05
—
110016479A
—
MA
Enumeration date
02/13/2006
Last updated
11/03/2020
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