Healthcare Provider Details

I. General information

NPI: 1306054853
Provider Name (Legal Business Name): DOMINIQUE BADIO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 HICKORY RD
NORTH ATTLEBORO MA
02760-4421
US

IV. Provider business mailing address

679 HICKORY RD
NORTH ATTLEBORO MA
02760-4421
US

V. Phone/Fax

Practice location:
  • Phone: 781-885-0861
  • Fax:
Mailing address:
  • Phone: 781-308-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN-2376523
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: