Healthcare Provider Details

I. General information

NPI: 1083029003
Provider Name (Legal Business Name): SUZANNA ZAGANJORI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 MILL ST STE 4
ARLINGTON MA
02476-4738
US

IV. Provider business mailing address

22 MILL ST STE 4
ARLINGTON MA
02476-4738
US

V. Phone/Fax

Practice location:
  • Phone: 781-551-0999
  • Fax: 781-551-3396
Mailing address:
  • Phone: 781-551-0999
  • Fax: 781-551-3396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN275926
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101511
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: