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General NPI Number Information
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NPI Number | 1588195986
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Entity Type | Individual
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Provider Name | ALEXANDRA DZIAMA NP
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Gender | Female
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 265 FRANKLIN ST STE 1702
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City | BOSTON
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State | MA
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Zip | 02110-3144
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Country | US
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Telephone | 781-915-4409
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Fax |
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Provider Business Mailing Address
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Address Line | 2 BAKER RD
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City | MEDFIELD
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State | MA
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Zip | 02052-1565
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Country | US
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Telephone | 781-915-4409
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2259036
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License Number State | MA
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