Healthcare Provider Details

I. General information

NPI: 1275458192
Provider Name (Legal Business Name): MARISA PICARIELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N INGALLS ST
ANN ARBOR MI
48109-2003
US

IV. Provider business mailing address

328 FRONT ST
WEYMOUTH MA
02188-2206
US

V. Phone/Fax

Practice location:
  • Phone: 734-764-7185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2383752
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: