Healthcare Provider Details

I. General information

NPI: 1134809866
Provider Name (Legal Business Name): MARIA JOSEFINA ANTONIO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 BOSTON RD
NORTH BILLERICA MA
01862-2310
US

IV. Provider business mailing address

PO BOX 24532
NEW YORK NY
10087-4532
US

V. Phone/Fax

Practice location:
  • Phone: 978-663-6666
  • Fax: 978-663-6716
Mailing address:
  • Phone: 781-774-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2317104
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.011436
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: