Carla Lynn Mongiacotti, RN
Individual provider Active NPI Pediatric Registered Nurse · Spencer, MA
NPI 1699890855 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699890855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- 214054 (MA)
- Practice address
- 77 Hastrup Road
Spencer, MA 01562 - Phone
- (774) 262-3513
- Fax
- (508) 885-5048
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214054 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 214054 | MA | Yes |
Addresses
Primary practice location
77 Hastrup Road
Spencer, MA 01562
Mailing address
425 Oakhill Road
Fitchburg, MA 01420
Phone (857) 413-7103
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0707341 | Other | MA | MASS HEALTH |
Other providers in Spencer, MA
- Robert Ernest Maloney
- Stefanie Mandeville
- Yasmin Matos
- Elizabeth Mendez
- Emily Mocerino
- Jodi Moynagh
- Mary W Muthiora
- Nasser S. Hanna, DDS, PC
- Karisa Nevalsky
- New Chapter Psychiatry, PLLC
All providers in Spencer, MA · Pediatric Registered Nurse in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.