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General NPI Number Information
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NPI Number | 1427056589
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Entity Type | Individual
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Provider Name | MICHAEL JOHN BERTUCCI NP
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 101 PAGE ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-3464
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Country | US
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Telephone | 508-973-5918
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Fax | 508-973-5916
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Provider Business Mailing Address
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Address Line | 200 MILL RD SUITE 180
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5252
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Country | US
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Telephone | 508-973-2000
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Fax | 508-973-2001
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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 | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | RN197511
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License Number State | MA
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