Basic Information
| Provider Information | |||||||||
| NPI: | 1528587045 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MASELLA | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PAPAGNI | ||||||||
| OtherFirstName: | KRISTINE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 37 FRIEND STREET | ||||||||
| Address2: | ELEMENT CARE INC. | ||||||||
| City: | LYNN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817156608 | ||||||||
| FaxNumber: | 7817156699 | ||||||||
| Practice Location | |||||||||
| Address1: | 29A EMERSON AVE | ||||||||
| Address2: | |||||||||
| City: | GLOUCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786759500 | ||||||||
| FaxNumber: | 9782810395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2272801 | MA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.