Provider Demographics
NPI:1033329636
Name:GENATOSSIO, CAROLYN SEVAL (RN,MPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SEVAL
Last Name:GENATOSSIO
Suffix:
Gender:F
Credentials:RN,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-3131
Mailing Address - Country:US
Mailing Address - Phone:508-359-5714
Mailing Address - Fax:
Practice Address - Street 1:333 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-3131
Practice Address - Country:US
Practice Address - Phone:508-359-5714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA109872163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics