Basic Information
| Provider Information | |||||||||
| NPI: | 1750986360 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOSSUTH | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 72 HARTFORD AVE E | ||||||||
| Address2: | |||||||||
| City: | MENDON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017561156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083808472 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 354 WAVERLEY ST | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017027079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082705700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2346348 | MA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.