Provider Demographics
NPI:1033618137
Name:ANDUJAR, DANIELLA G (RN)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:G
Last Name:ANDUJAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-3859
Mailing Address - Country:US
Mailing Address - Phone:857-544-6606
Mailing Address - Fax:
Practice Address - Street 1:251 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4136
Practice Address - Country:US
Practice Address - Phone:978-475-4503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301575163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health