Provider Demographics
NPI:1073614269
Name:RAGONESE, SUZANNE (ANP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:RAGONESE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD
Mailing Address - Street 2:STE 5
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-2709
Practice Address - Street 1:1280 W CENTRAL ST STE 301
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3110
Practice Address - Country:US
Practice Address - Phone:085-282-7005
Practice Address - Fax:508-528-5759
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152487363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health