Healthcare Provider Details

I. General information

NPI: 1497381768
Provider Name (Legal Business Name): ARIEL CONSOLMAGNO RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIEL IDICA RRT

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LINCOLN ST
FRAMINGHAM MA
01702-6358
US

IV. Provider business mailing address

2218 JEFFERSON PL
BELLINGHAM MA
02019-6300
US

V. Phone/Fax

Practice location:
  • Phone: 508-383-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT10724
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: