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General NPI Number Information
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NPI Number | 1750007084
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Entity Type | Individual
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Provider Name | PAUL MAGAZZU NP
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Gender | Male
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 235 WELLESLEY ST STE 1
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City | WESTON
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State | MA
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Zip | 02493-1571
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Country | US
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Telephone | 781-768-8207
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Fax |
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Provider Business Mailing Address
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Address Line | 105 ARCADIA AVE
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City | READING
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State | MA
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Zip | 01867-2207
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Country | US
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Telephone | 781-439-8376
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN2350595
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License Number State | MA
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