Peter James Massoglia, LPN

Individual provider Active NPI Licensed Practical Nurse · Ironwood, MI

NPI 1669790242 · NPPES record last updated May 6, 2010

Key facts

NPI
1669790242
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
310628-031 (WI)
Practice address
117 W Norrie St
Ironwood, MI 49938-2430
Phone
(906) 932-8091
NPI assigned
May 6, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
310628-031WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 310628-031 WI Yes

Addresses

Primary practice location

117 W Norrie St
Ironwood, MI 49938-2430

Mailing address

117 W Norrie St
Ironwood, MI 49938-2430
Phone (906) 932-8091

Other providers in Ironwood, MI

All providers in Ironwood, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.