Julia Mancuso

Individual provider Active NPI Certified Registered Nurse Anesthetist · South Weymouth, MA

NPI 1922474972 · NPPES record last updated Aug 13, 2015

Key facts

NPI
1922474972
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
2266454 (MA)
Practice address
55 Fogg Rd
South Weymouth, MA 02190-2432
Phone
(781) 624-8000
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2266454MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Anesthesia Associates, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2266454 MA Yes

Addresses

Primary practice location

55 Fogg Rd
South Weymouth, MA 02190-2432

Mailing address

55 Fogg Rd
South Weymouth, MA 02190-2432

Other providers in South Weymouth, MA

All providers in South Weymouth, MA · Certified Registered Nurse Anesthetist in Massachusetts

Sources for this page

Verify at the official NPI Registry.