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General NPI Number Information
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NPI Number | 1003502253
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Entity Type | Individual
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Provider Name | RAISA CUCCIO NP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 41 MALL RD
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City | BURLINGTON
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State | MA
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Zip | 01805-2765
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Country | US
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Telephone | 781-744-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 171 MAIN ST STE 203B
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City | ASHLAND
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State | MA
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Zip | 01721-1187
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Country | US
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Telephone | 508-881-3029
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Fax | 508-881-1752
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN2304866
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2304866
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License Number State | MA
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