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NPI Code Detail

MEDICARE: MARIE FEDERICO CNP, AGACNP-BC, RN

MEDICARE: MARIE FEDERICO CNP, AGACNP-BC, RN
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
1363LA2100XAcute Care Nurse PractitionerRN2285258MA
2163W00000XRegistered NurseRN2285258MA

General Provider Information

NPI Number : 1982033288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE FEDERICO CNP, AGACNP-BC, RN
Provider Business Mailing Address
First Line : 398 NEPONSET AVE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3134
Country : US
Telephone Number : 617-282-3200
Fax Number :
Provider Business Practice Location Address
First Line : 398 NEPONSET AVE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3134
Country : US
Telephone Number : 617-282-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2013
Last Update Date : 02/04/2026

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