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General NPI Number Information
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NPI Number | 1255882684
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Entity Type | Individual
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Provider Name | STEPHANIE A RANDAZZO PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 88 LINCOLN ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-6354
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Country | US
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Telephone | 508-620-0010
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Fax | 508-626-7625
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Provider Business Mailing Address
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Address Line | 88 LINCOLN ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-6354
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Country | US
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Telephone | 508-620-0010
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Fax | 508-626-7625
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN263039
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License Number State | MA
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