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NPI Code Detail

MEDICARE: MS. MARY DIGANGI PA MS

MEDICARE: MS. MARY DIGANGI PA MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2291MA

General Provider Information

NPI Number : 1386624138
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY DIGANGI PA MS
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number : 800-225-8885
Fax Number : 978-343-5390
Provider Business Practice Location Address
First Line : 326 NICHOLS RD
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-1914
Country : US
Telephone Number : 978-343-5270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 11/16/2020

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